CMS Price Transparency Data

Blood test, liver function panel

Facility: Othello Community Hospital

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $119
Cash Discount Price: $112
vs. Medicare Baseline: 14.57x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at Othello Community Hospital is $119. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 14.57x the Medicare baseline. Located in 315 North 14Th Avenue, Othello, WA.

Cash / Self-Pay

$112

Average discount available for prompt cash payment at this facility.

Insurance Median

$119

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: $112 (1371%)

Insurance Median: $119 (1457%)

Cash: $112 (1371% of Medicare)

Ins. Median: $119 (1457% 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 1457% of the Medicare baseline (a markup of 1357%). 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
Ambetter / Centene	$63 - $64	771%
Amerigroup Mcaid	$63	771%
Chp Mcaid	$63	771%
Cocare - All Plans	$63	771%
Gau - All Plans	$63	771%
Kaiser - All Plans	$63	771%
Molina Mcaid	$63	771%
UnitedHealthcare	$63 - $149	771%
Chp - All Other Plans	$64	783%
Molina - All Other Plans	$64	783%
Medicare (plans)	$74	906%
Tricare	$97	1187%
Triwest - All Plans	$97	1187%
Asuris - All Plans	$119	1457%
Commercial Other - All Plans	$119	1457%
Hma - All Plans	$119	1457%
Hmso - All Plans	$119	1457%
Tpsc - All Plans	$119	1457%
Travelers - All Plans	$119	1457%
Veterans Admin - All Plans	$119	1457%
Blue Cross Blue Shield	$125	1530%
Cigna	$133	1628%
First Choice - All Plans	$134	1640%
Aetna	$140	1714%
Chp Mcr Adv	$149	1824%
Health Alliance Mcr Adv - All Plans	$149	1824%
Humana	$149	1824%
Molina Mcare	$149	1824%
Wellcare Mcr Adv - All Plans	$149	1824%

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 $112.
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 Othello Community Hospital 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.