CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Mercy Rehabilitation Hospital Northwest Arkansas

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $46
Cash Discount Price: $53
vs. Medicare Baseline: 4.36x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Mercy Rehabilitation Hospital Northwest Arkansas is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $53. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 4.36x the Medicare baseline. Located in 4313 S Pleasant Crossing Blvd, Rogers, AR.

Cash / Self-Pay

$53

Average discount available for prompt cash payment at this facility.

Insurance Median

$46

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: $53 (502%)

Insurance Median: $46 (436%)

Cash: $53 (502% of Medicare)

Ins. Median: $46 (436% 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 436% of the Medicare baseline (a markup of 336%). 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
Phcs	$36 - $47	341%
Multiplan	$39 - $51	369%
Aetna	$46 - $60	436%
Ambetter / Centene	$46 - $60	436%
American Health Plan	$46 - $60	436%
Arkansas Total Care (Passe)	$46 - $60	436%
Blue Cross Blue Shield	$46 - $60	436%
Care Source (Passe)	$46 - $60	436%
Cigna	$46 - $60	436%
Devoted	$46 - $60	436%
Empower	$46 - $60	436%
Essence	$46 - $60	436%
Humana	$46 - $60	436%
Medicaid / KanCare	$46 - $60	436%
Medicare (plans)	$46 - $60	436%
Municipal League	$46 - $60	436%
Qualchoice	$46 - $60	436%
Summit (Passe)	$46 - $60	436%
UnitedHealthcare	$46 - $60	436%
Vaccn	$46 - $60	436%

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 $53.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80053.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercy Rehabilitation Hospital Northwest Arkansas is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 80053.
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.