CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Sarah D Culbertson Memorial Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $257
  • Cash Discount Price: $257
  • vs. Medicare Baseline: 24.34x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Sarah D Culbertson Memorial Hospital is $257. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $257. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 24.34x the Medicare baseline. Located in 238 South Congress Street, Rushville, IL.
Cash / Self-Pay
$257

Average discount available for prompt cash payment at this facility.

Insurance Median
$257

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: $257 (2434%)
Insurance Median: $257 (2434%)
Cash: $257 (2434% of Medicare)
Ins. Median: $257 (2434% 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 2434% of the Medicare baseline (a markup of 2334%). 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 $24 - $257 227%
Blue Cross Blue Shield $24 - $280 227%
Corvel-All Plans $24 227%
Meridian Hp Mcaid-All Plans $24 227%
Molina Healthcare Mcaid $24 227%
Humana $123 1165%
Molina Mmai-All Other Plans $123 1165%
UnitedHealthcare $123 - $257 1165%
Cigna $211 1998%
Beech Street-All Plans $257 2434%
Encompass-All Plans $257 2434%
Health Dynamics-All Plans $257 2434%
Healthlink-All Plans $257 2434%
Hfn Epo $257 2434%
Hfn Ppo Ip/Op Only-All Other Plans $257 2434%
Multiplan/Phcs-All Plans $257 2434%
Preferred Medical Claims Solution-All Plans $257 2434%
Three Rivers Provider Network-All Plans $257 2434%
Wexford Ip/Op Only-All Plans $257 2434%
Healthsmart-All Plans $272 2576%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 238 South Congress Street, Rushville, IL 62681
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals