CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Warner Hospital and Health Services

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $250
Cash Discount Price: $306
vs. Medicare Baseline: 23.67x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Warner Hospital and Health Services is $250. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $306. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 23.67x the Medicare baseline. Located in 422 W White St, Clinton, IL.

Cash / Self-Pay

$306

Average discount available for prompt cash payment at this facility.

Insurance Median

$250

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: $306 (2898%)

Insurance Median: $250 (2367%)

Cash: $306 (2898% of Medicare)

Ins. Median: $250 (2367% 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 2367% of the Medicare baseline (a markup of 2267%). 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	$28 - $264	265%
Blue Cross Blue Shield	$28 - $305	265%
Harmony Hp Mcaid-All Plans	$28	265%
Medicaid / KanCare	$28	265%
Meridian Hp-All Plans	$28	265%
Molina-All Other Plans	$28	265%
Health Alliance Med Adv	$124 - $128	1174%
Humana	$124 - $264	1174%
Molina Mcr/Mcd Dual	$124 - $128	1174%
UnitedHealthcare	$124 - $264	1174%
Wellcare Mcr Adv-All Plans	$124 - $128	1174%
Healthlink Hmo	$235 - $243	2225%
City Of Clinton (Employees Serv)-All Plans	$241 - $249	2282%
Cigna	$250 - $258	2367%
Caterpillar-All Plans	$256 - $264	2424%
Multiplan Phcs-All Plans	$256 - $264	2424%
Health Alliance-All Other Plans	$265 - $274	2509%
Healthlink Ppo/Work Comp-All Other Plans	$265 - $274	2509%
Consociate Care Ppo-All Plans	$271 - $280	2566%
Hfn Ppo/Epo-All Plans	$271 - $280	2566%
Three Rivers-All Plans	$286 - $296	2708%

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 $306.
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 Warner Hospital and Health Services 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.