CMS Price Transparency Data

Blood test, liver function panel

Facility: Margaretville Memorial Hospital

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $105
Cash Discount Price: $238
vs. Medicare Baseline: 12.85x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at Margaretville Memorial Hospital is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $238. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 12.85x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.

Cash / Self-Pay

$238

Average discount available for prompt cash payment at this facility.

Insurance Median

$105

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: $238 (2913%)

Insurance Median: $105 (1285%)

Cash: $238 (2913% of Medicare)

Ins. Median: $105 (1285% 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 1285% of the Medicare baseline (a markup of 1185%). 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
Oxford	$12	147%
UnitedHealthcare	$12 - $105	147%
Aetna	$22 - $238	269%
Mvp	$35	428%
Blue Cross Blue Shield	$38 - $105	465%
Mvp Hmo/Ppo	$41	502%
Self-Pay	$54	661%
Mvp Gold (McR)	$105	1285%
Medicare (plans)	$105 - $157	1285%
Hamaspik (McR)	$105	1285%
Affinity By Molina McR	$110	1346%
Cdphp	$115	1408%
Emblem Ghi/Hip Ppo/Cbp	$148	1812%
Mvp Exchange	$155	1897%
Emblem Select Care (Exchange)	$162	1983%
Magnacare Standard	$167	2044%
Oxford Exchange	$167	2044%
Todays Options	$173	2118%
Emblem Ghi/Hip Hmo/Epo/Pos	$190	2326%
Multiplan	$195	2387%
First Health	$214	2619%
Magnacare Preferred	$940	11506%

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 $238.
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 Margaretville Memorial 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.