CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Mercyone Elkader Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $143
Cash Discount Price: $126
vs. Medicare Baseline: 13.54x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Mercyone Elkader Medical Center is $143. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $126. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 13.54x the Medicare baseline. Located in 901 Davidson Street Nw, Elkader, IA.

Cash / Self-Pay

$126

Average discount available for prompt cash payment at this facility.

Insurance Median

$143

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: $126 (1193%)

Insurance Median: $143 (1354%)

Cash: $126 (1193% of Medicare)

Ins. Median: $143 (1354% 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 1354% of the Medicare baseline (a markup of 1254%). 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
Blue Cross Blue Shield	$100	947%
Aetna	$101 - $143	956%
Medicare (plans)	$102 - $105	966%
UnitedHealthcare	$107 - $146	1013%
Iowa Total Care	$121	1146%
Medicaid / KanCare	$122 - $123	1155%
Amish Hospital Aid	$134	1269%
1199 National Benefit Fund	$143	1354%
Allied Benefit Systems	$143	1354%
Asr Health Benefits	$143	1354%
Christian Brother Services	$143	1354%
Coventry	$143	1354%
First Health	$143	1354%
Lucent Health	$143	1354%
Luminare Health	$143	1354%
Medical Mutual	$143	1354%
Meritain	$143	1354%
Trustmark Small Business Benefits	$143	1354%
Webtpa	$143	1354%
Geha	$146	1383%
Centivo	$151	1430%
Health Choices	$155	1468%
Medical Associates	$155	1468%
Ambetter / Centene	$169	1600%
Health Partners	$187	1771%
Auxiant	$190	1799%
Cigna	$190	1799%
Medica	$190	1799%
Midlands	$190	1799%
Midlands Choice	$190	1799%
Crime Victim Assistance	$194	1837%
Iowa Dept Of Public Health	$194	1837%
Claimdoc	$203	1922%
Nova	$203	1922%

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 $126.
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 Mercyone Elkader Medical Center 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.