CMS Price Transparency Data

Blood test, liver function panel

Facility: Carilion Stonewall Jackson Hospital

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $73
  • Cash Discount Price: $40
  • vs. Medicare Baseline: 8.94x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Carilion Stonewall Jackson Hospital is $73. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 8.94x the Medicare baseline. Located in 1 Health Circle, Lexington, VA.
Cash / Self-Pay
$40

Average discount available for prompt cash payment at this facility.

Insurance Median
$73

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: $40 (490%)
Insurance Median: $73 (894%)
Cash: $40 (490% of Medicare)
Ins. Median: $73 (894% 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 894% of the Medicare baseline (a markup of 794%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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%
Sentara Health Plan $9 - $71 110%
Abh of Wva (Formerly Coventry) $9 110%
UnitedHealthcare $9 - $93 110%
Humana $9 110%
Blue Cross Blue Shield $9 110%
Aetna $58 - $76 710%
Gateway - Tier 3 $63 771%
Vhn - Ultra $71 869%
Connecticare $80 979%
Cigna $91 1114%
Gateway - Tier 2 $91 1114%
Vhn - Plus $91 1114%
Vhn $97 1187%
Integrated Health Plan $97 1187%
Vhn - Link $103 1261%
Beech Street $105 1285%
Gateway - Tier 1 $108 1322%
Vhn - Secondary Payors $108 1322%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Health Circle, Lexington, VA 24450
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals