CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Mercyone Des Moines Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $136
  • Cash Discount Price: $1,728
  • vs. Medicare Baseline: 12.88x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Mercyone Des Moines Medical Center is $136. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,728. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 12.88x the Medicare baseline. Located in 1111 6Th Ave, Des Moines, IA.
Cash / Self-Pay
$1,728

Average discount available for prompt cash payment at this facility.

Insurance Median
$136

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: $1,728 (16364%)
Insurance Median: $136 (1288%)
Cash: $1,728 (16364% of Medicare)
Ins. Median: $136 (1288% 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 1288% of the Medicare baseline (a markup of 1188%). 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 $10 - $163 95%
Blue Cross Blue Shield $10 - $136 95%
Iowa Total Care $10 - $126 95%
Medicaid / KanCare $10 - $127 95%
Medicare (plans) $10 - $131 95%
Geha $11 104%
UnitedHealthcare $11 - $469 104%
Amish Hospital Aid $14 - $107 133%
Centivo $15 - $116 142%
Oscar $15 - $114 142%
Ambetter / Centene $18 - $135 170%
Claimdoc $21 - $162 199%
Nova $21 - $162 199%
Iowa Dept Of Public Health $89 - $469 843%
Health Choices $94 890%
Medical Associates $94 890%
Blue Benefit Administrators Of Massachusetts $136 1288%
Blue Care Network $136 1288%
Blue Distinction Transplant $136 1288%
Blue Shield - Ca $136 1288%
Blue Shield - Id (Regence) $136 1288%
Blue Shield - Ny Highmark Northeastern $136 1288%
Blue Shield - Ny Highmark Western $136 1288%
Blue Shield - Pa (Highmark) $136 1288%
Blue Shield - Wa (Regence) $136 1288%
1199 National Benefit Fund $163 1544%
Allied Benefit Systems $163 1544%
Asr Health Benefits $163 1544%
Christian Brother Services $163 1544%
Coventry $163 1544%
First Health $163 1544%
Lucent Health $163 1544%
Luminare Health $163 1544%
Medical Mutual $163 1544%
Meritain $163 1544%
Trustmark Small Business Benefits $163 1544%
Webtpa $163 1544%
Cigna $281 2661%
Health Partners $298 2822%
Auxiant $305 2888%
Medica $305 2888%
Midlands $305 2888%
Midlands Choice $305 2888%
Usa Managed Care $399 3778%
Crime Victim Assistance $469 4441%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1111 6Th Ave, Des Moines, IA 50314
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals