CMS Price Transparency Data

Blood test, liver function panel

Facility: Porter Hospital Inc

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $56
  • Cash Discount Price: $101
  • vs. Medicare Baseline: 6.85x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Porter Hospital Inc is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $101. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 6.85x the Medicare baseline. Located in 115 Porter Drive, Middlebury, VT.
Cash / Self-Pay
$101

Average discount available for prompt cash payment at this facility.

Insurance Median
$56

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: $101 (1236%)
Insurance Median: $56 (685%)
Cash: $101 (1236% of Medicare)
Ins. Median: $56 (685% 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 685% of the Medicare baseline (a markup of 585%). 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
Humana $8 98%
Fidelis Care $43 526%
Aetna $47 575%
Capital District Physicians' Health Plan $47 - $84 575%
Martins Point $47 575%
Mvp $47 - $94 575%
UnitedHealthcare $47 - $100 575%
Veterans Affairs Community Care Network $47 575%
Veterans Choice $47 575%
Blue Cross Blue Shield $48 - $98 588%
Wellpath $56 685%
Harvard Pilgrim $81 991%
Coventry $89 1089%
Cigna $92 1126%
Medical Corporation $96 1175%
Multiplan $96 1175%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 115 Porter Drive, Middlebury, VT 05753
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals