Blood test, comprehensive metabolic panel
Facility: Salina Regional Health Center
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $185
- Cash Discount Price: $144
- vs. Medicare Baseline: 17.52x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 1752% of the Medicare baseline (a markup of 1652%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $14 - $15 | 133% |
| Preferred Phsic | $123 | 1165% |
| Preferred Healthcare - All Other Plans | $166 | 1572% |
| Multiplan (Mpi)-All Plans | $185 | 1752% |
| Aetna | $185 | 1752% |
| Providers Care (Wppa)-All Plans | $185 | 1752% |
| Cigna | $185 | 1752% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel (CPT 80053) at Salina Regional Health Center in Salina, Kansas, the facility's cash median price of $144.00 is lower than the state average, which is $166.00. While the facility's negotiated rate of $185.00 is higher than the cash price, patients with high-deductible plans may find paying the cash rate directly more cost-effective if their insurance allowed amount exceeds $144.00. It is important to note that commercial insurance rates often include administrative overhead, making the cash price a useful benchmark for determining the true cost of the service.
The facility's negotiated rate of $185.00 is 17.5% higher than the Medicare benchmark of $10.56, which serves as the objective baseline for evaluating pricing markups. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, it is still advisable to request an itemized bill to verify that no unbundled codes or services not rendered are included. Additionally, patients should explicitly ask about prompt-pay discounts before scheduling, as paying the cash price upfront can sometimes result in further savings compared to the standard negotiated rate.