CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Audubon County Memorial Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $67
Cash Discount Price: $75
vs. Medicare Baseline: 6.34x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Audubon County Memorial Hospital is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $75. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 6.34x the Medicare baseline. Located in 515 Pacific Avenue, Audubon, IA.

Cash / Self-Pay

$75

Average discount available for prompt cash payment at this facility.

Insurance Median

$67

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: $75 (710%)

Insurance Median: $67 (634%)

Cash: $75 (710% of Medicare)

Ins. Median: $67 (634% 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 634% of the Medicare baseline (a markup of 534%). 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
Aetna	$54 - $68	511%
Tricare	$54	511%
Wellmark Hmo	$61	578%
UnitedHealthcare	$64	606%
Wellmark Ppo - All Other Plans	$67	634%
Midlands Choice - All Plans	$74	701%
Molina Mcaid - All Plans	$75	710%
Iowa Total Care Mcaid - All Plans	$76	720%
Amerigroup Mcaid - All Plans	$79	748%

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 $75.
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 Audubon County Memorial 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.