CMS Price Transparency Data

Blood test, liver function panel

Facility: St Josephs Community Hospital West Bend

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $127
  • Cash Discount Price: $117
  • vs. Medicare Baseline: 15.54x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at St Josephs Community Hospital West Bend is $127. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $117. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 15.54x the Medicare baseline. Located in 3200 Pleasant Valley Road, West Bend, WI.
Cash / Self-Pay
$117

Average discount available for prompt cash payment at this facility.

Insurance Median
$127

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: $117 (1432%)
Insurance Median: $127 (1554%)
Cash: $117 (1432% of Medicare)
Ins. Median: $127 (1554% 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 1554% of the Medicare baseline (a markup of 1454%). 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
Aetna $8 - $148 98%
Allwell $8 98%
Blue Cross Blue Shield $8 - $41 98%
Care Wisconsin $8 98%
Community Care $8 98%
Health Partners $8 - $138 98%
Humana $8 98%
Icare $8 98%
Molina $8 98%
Network Health Plan $8 - $10 98%
Security Health Plan Secure Savers $8 98%
UnitedHealthcare $8 - $70 98%
Sheboygan Employers Health Network $10 122%
Centivo $64 - $70 783%
Froedtert South $89 1089%
Chorus Community Health Plan $91 1114%
Common Ground $127 1554%
Health Payment Systems $134 - $171 1640%
Wisconsin Physician Services $170 2081%
Trilogy $174 2130%
Americas Choice $184 2252%
Healtheos $184 2252%
Multiplan/Private Healthcare Systems $184 2252%
First Health Network $187 2289%
Hfn $191 2338%
Ibsi Passport $191 2338%
Cigna $201 2460%
Healthsmart $201 2460%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3200 Pleasant Valley Road, West Bend, WI 53095
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals