Blood test, comprehensive metabolic panel
Facility: Mercy Hospital Pittsburg, Inc
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $17
- Cash Discount Price: $144
- vs. Medicare Baseline: 1.61x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $9 - $18 | 85% |
| Aetna | $9 - $188 | 85% |
| Humana | $9 - $10 | 85% |
| Blue Cross Blue Shield | $10 - $27 | 95% |
| Medicare (plans) | $10 | 95% |
| Mercy Hospice Okc [20252] | $10 | 95% |
| Dept Of Veteran Affairs Contracted [320106] | $10 | 95% |
| Kindful Hospice [20434] | $10 | 95% |
| Pace Of The Ozarks Contracted [320518] | $10 | 95% |
| UnitedHealthcare | $10 - $149 | 95% |
| Cross Timbers Hospice [20098] | $10 | 95% |
| Elara Caring Aspire Hospice [20433] | $10 | 95% |
| Medica Contracted [320239] | $10 | 95% |
| Kindful Hospice Contracted [320434] | $10 | 95% |
| Halo Hcr Inc Hospice Contracted [320432] | $10 | 95% |
| Halo Hcr Inc Hospice [20432] | $10 | 95% |
| Tricare | $10 | 95% |
| American Health Advantage Of Ks Mcr Contracted [320508] | $11 | 104% |
| Health Choice Contracted [320166] | $14 | 133% |
| Ambetter / Centene | $18 | 170% |
| Home State Health Plan Contracted [320187] | $18 | 170% |
| Providrs Care Network Contracted [320484] | $20 | 189% |
| Cigna | $58 - $60 | 549% |
| United Medical Resources Contracted [320454] | $149 | 1411% |
| Ebms Contracted [320493] | $177 | 1676% |
| Healthlink Contracted [320179] | $177 | 1676% |
| Reflect Health Contracted [320492] | $177 | 1676% |
| Imagine 360 Contracted [320494] | $177 | 1676% |
| Edison Health Solutions Contracted [320502] | $177 | 1676% |
| Yuzu Health Contracted [320521] | $177 | 1676% |
| Auxiant Contracted [320462] | $177 | 1676% |
| Workers Comp [20426] | $177 | 1676% |
| Mercy Benefit Admin Contracted [320251] | $177 | 1676% |
| Aither Health Contracted [320449] | $177 | 1676% |
| American Healthcare Alliance Contracted [320020] | $177 | 1676% |
| First Health Contracted [320128] | $188 | 1780% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel (CPT 80053), Mercy Hospital Pittsburg, Inc. lists a gross charge of $221.00, which is significantly higher than the facility's own cash median of $144.00 and the state of Kansas average. While the Medicare benchmark rate for this service is $10.56, commercial negotiated rates vary widely across payers, ranging from $9 to $188. Patients should be aware that insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures; in this case, the cash median is notably lower than the highest negotiated rates found for UnitedHealthcare and several contracted entities. Because commercial rates can sometimes be higher than self-pay options, individuals with high-deductible plans may find it financially advantageous to pay the cash price directly, provided they verify the facility's "self-pay" or "prompt-pay" discounts before scheduling.
The facility's cash median of $144.00 is also substantially higher than the median paid amount of $11.00, highlighting the significant impact of insurance deductibles and co-pays on final out-of-pocket costs. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, unexpected charges can still occur if ancillary services are billed separately. To ensure transparency, patients should request a full itemized billing audit before paying any invoice, as summary bills often obscure individual line items and potential errors. Given that over 80% of hospital bills contain mistakes, reviewing the detailed statement for unbundled codes or services not rendered is a critical step in reducing medical debt. Finally, since the