CMS Price Transparency Data
Blood test, comprehensive metabolic panel
Facility: Mercy Hospital Ozark
Billing Code: 80053 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80053
- Insurance Median: $59
- Cash Discount Price: $128
- vs. Medicare Baseline: 5.59x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Mercy Hospital Ozark is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $128. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 5.59x the Medicare baseline. Located in 801 West River Street, Ozark, AR.
Cash / Self-Pay
$128
Average discount available for prompt cash payment at this facility.
Insurance Median
$59
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$10.56
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $10.56 (100%)
Cash / Self-Pay: $128 (1212%)
Insurance Median: $59 (559%)
Cash: $128 (1212% of Medicare)
Ins. Median: $59 (559% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $10.56 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 559% of the Medicare baseline (a markup of 459%). 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 |
|---|---|---|
| Medicaid / KanCare | $9 - $80 | 85% |
| United Medical Resources Contracted [320454] | $11 | 104% |
| UnitedHealthcare | $11 - $58 | 104% |
| Summit Community Care Contracted [320368] | $15 | 142% |
| Summit Community Care [20368] | $15 | 142% |
| Blue Cross Blue Shield | $16 - $58 | 152% |
| Usable Contracted [320409] | $16 | 152% |
| Novasys Contracted [320285] | $25 - $80 | 237% |
| Arkansas Total Care Contracted [320039] | $34 | 322% |
| Qual Choice Contracted [320324] | $46 | 436% |
| Aetna | $58 - $128 | 549% |
| American Health Advantage Of Mo Mcr [20264] | $58 | 549% |
| Cherokee Nation Health Serv Contracted [320066] | $58 | 549% |
| Cross Timbers Hospice [20098] | $58 | 549% |
| Dept Of Veteran Affairs Contracted [320106] | $58 | 549% |
| Elara Caring Aspire Hospice Contracted [320433] | $58 | 549% |
| Elara Caring Aspire Hospice [20433] | $58 | 549% |
| Globalhealth Contracted [320145] | $58 | 549% |
| Halo Hcr Inc Hospice Contracted [320432] | $58 | 549% |
| Halo Hcr Inc Hospice [20432] | $58 | 549% |
| Humana | $58 - $167 | 549% |
| Independent Health [20197] | $58 | 549% |
| Indian Health Service Contracted [320198] | $58 | 549% |
| Indian Health Service [20198] | $58 | 549% |
| Jordan Valley Senior Care Pace [20515] | $58 | 549% |
| Kindful Hospice Contracted [320434] | $58 | 549% |
| Kindful Hospice [20434] | $58 | 549% |
| Medical Associates Health [20444] | $58 | 549% |
| Medicare (plans) | $58 - $61 | 549% |
| Mercy Hospice Okc [20252] | $58 | 549% |
| Pace Of The Ozarks [20518] | $58 | 549% |
| Provider Partners Health Plans Contracted [320450] | $58 | 549% |
| Qual Choice Contracted [320325] | $58 | 549% |
| Spina Bifida Hlthcare Benefit [20506] | $58 | 549% |
| Tricare | $58 | 549% |
| Valir Pace [20503] | $58 | 549% |
| Wellfirst Health Mcr [20443] | $58 | 549% |
| Cigna | $61 - $167 | 578% |
| Mercy Interfacility [20513] | $65 | 616% |
| Ambetter / Centene | $80 | 758% |
| Home State Health Plan Contracted [320187] | $80 | 758% |
| Auxiant Contracted [320462] | $118 - $177 | 1117% |
| Mercy Benefit Admin Contracted [320251] | $118 - $177 | 1117% |
| Workers Comp [20426] | $128 | 1212% |
| 90 Degree Benefits Contracted [320436] | $167 | 1581% |
| Aither Health Contracted [320449] | $167 | 1581% |
| Ebms Contracted [320493] | $167 | 1581% |
| Edison Health Solutions Contracted [320502] | $167 | 1581% |
| Healthlink Contracted [320179] | $167 - $177 | 1581% |
| Imagine 360 Contracted [320494] | $167 | 1581% |
| Multiplan Contracted [320270] | $167 | 1581% |
| Multiplan [20270] | $167 | 1581% |
| Municipal Health Plan Contracted [320271] | $167 | 1581% |
| Reflect Health Contracted [320492] | $167 | 1581% |
| Show-Me Health Administrators Contracted [320483] | $167 | 1581% |
| Federal Medical Center Contracted [320127] | $177 | 1676% |
| Healthscope Contracted [320182] | $177 | 1676% |
| Insurance System Inc Contracted [320465] | $177 | 1676% |
| Personify Health Contracted [320051] | $177 | 1676% |
| Point C Contracted [320238] | $177 | 1676% |
| Preferred Health Plan Contracted [320522] | $177 | 1676% |
| Tri State Healthcare Coalition Contracted [320379] | $177 | 1676% |