CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Franklin General Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $162
Cash Discount Price: $333
vs. Medicare Baseline: 15.34x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Franklin General Hospital is $162. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $333. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 15.34x the Medicare baseline. Located in 1720 Central Avenue East, Hampton, IA.

Cash / Self-Pay

$333

Average discount available for prompt cash payment at this facility.

Insurance Median

$162

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: $333 (3153%)

Insurance Median: $162 (1534%)

Cash: $333 (3153% of Medicare)

Ins. Median: $162 (1534% 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 1534% of the Medicare baseline (a markup of 1434%). 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
UnitedHealthcare	$37 - $320	350%
Wellmark Hmo	$52	492%
Wellmark Ppo - All Other Plans	$57	540%
Medical Associates Mcare	$142 - $154	1345%
Mount Carmel Hp-All Plans	$142 - $154	1345%
Tricare	$142 - $154	1345%
Amerigroup Mcare	$143 - $156	1354%
Wellmark Mcr Adv	$143 - $156	1354%
Molina Mcare	$147 - $160	1392%
Ambetter / Centene	$148 - $246	1402%
American Hp Iowa - All Plans	$149 - $162	1411%
Amerigroup Mcaid - All Other Plans	$149 - $163	1411%
Molina Mcaid - All Other Plans	$150 - $163	1420%
Centivo - All Plans	$212 - $231	2008%
Medical Ass Hosp Employer Group	$212 - $231	2008%
Oscar - All Plans	$212 - $231	2008%
Midlands Choice-All Plans	$248 - $270	2348%
Medical Associates Hp-All Other Plans	$301 - $327	2850%
Preferred Health Choices-All Plans	$301 - $327	2850%
Splashlight Llc-All Plans	$301 - $327	2850%
Aetna	$329 - $366	3116%
Multiplan-All Plans	$336 - $366	3182%

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 $333.
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 Franklin General Hospital 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.