CMS Price Transparency Data

Blood test, liver function panel

Facility: Carilion Medical Center

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $148
Cash Discount Price: $83
vs. Medicare Baseline: 18.12x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at Carilion Medical Center is $148. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $83. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 18.12x the Medicare baseline. Located in 1906 Belleview Avenue, Se, Roanoke, VA.

Cash / Self-Pay

$83

Average discount available for prompt cash payment at this facility.

Insurance Median

$148

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$8.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.17 (100%)

Cash / Self-Pay: $83 (1016%)

Insurance Median: $148 (1812%)

Cash: $83 (1016% of Medicare)

Ins. Median: $148 (1812% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.17 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1812% of the Medicare baseline (a markup of 1712%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Abh Of Va (Formerly Coventry)	$9	110%
Abh Of Wva (Formerly Coventry)	$9	110%
Blue Cross Blue Shield	$9	110%
Humana	$9	110%
Sentara Health Plan	$9 - $148	110%
UnitedHealthcare	$9 - $195	110%
Aetna	$121 - $158	1481%
Gateway - Tier 3	$131	1603%
Vhn - Ultra	$148	1812%
Cigna	$160 - $171	1958%
Connecticare	$167	2044%
Vhn - Plus	$183	2240%
Gateway - Tier 2	$190	2326%
Vhn	$190	2326%
Vhn - Link	$214	2619%
Gateway - Tier 1	$226	2766%
Vhn - Secondary Payors	$226	2766%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $83.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80076.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Carilion Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 80076.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.