Blood test, comprehensive metabolic panel
Facility: Saint John Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $11
- Cash Discount Price: $10
- vs. Medicare Baseline: 1.04x 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 |
|---|---|---|
| Healthy Blue | $11 | 104% |
| UnitedHealthcare | $11 - $15 | 104% |
| Celtic | $11 - $187 | 104% |
| Kansas Superior Select | $11 | 104% |
| Medicaid / KanCare | $11 | 104% |
| Aetna | $11 - $18 | 104% |
| Midland Care Connection | $11 | 104% |
| Medicare (plans) | $11 | 104% |
| Blue Cross Blue Shield | $11 - $23 | 104% |
| Tricare | $11 | 104% |
| Cigna | $11 | 104% |
| Well Path | $15 | 142% |
| Employer Direct Healthcare | $15 | 142% |
| Corizon | $15 | 142% |
| Naphcare | $16 | 152% |
| Centurion | $16 | 152% |
| Comp Alliance Workers Comp | $21 | 199% |
| Worker Compensation | $23 | 218% |
| Oha Networks | $23 | 218% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel (CPT 80053) at Saint John Hospital in Leavenworth, KS, the facility's cash price of $10.00 is significantly lower than the state average of $11.00 and the county average of $11.00. While the hospital's negotiated rates with major payers like UnitedHealthcare and Aetna range from $11 to $18, these amounts often exceed the cash price, meaning patients with high-deductible plans or those without insurance could save money by paying the cash rate directly. It is important to note that commercial insurance contracts can sometimes result in higher out-of-pocket costs than self-pay options, so verifying the specific allowed amount for your plan before scheduling is essential.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, unexpected charges can still occur if ancillary services are billed separately. To ensure accuracy, request a full itemized bill before paying, as summary invoices may obscure errors or unbundled codes. Additionally, ask the billing department about prompt-pay discounts, which can reduce the final amount owed by 20% to 50% if paid in full upfront, bypassing the administrative costs associated with insurance claims processing.