Blood test, comprehensive metabolic panel
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $74
- Cash Discount Price: $54
- vs. Medicare Baseline: 7.01x 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 701% of the Medicare baseline (a markup of 601%). 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 |
|---|---|---|
| Hooray Health [8000] | $74 | 701% |
| Healthcare Highways [2210] | $74 | 701% |
| Black Lung [6055] | $74 | 701% |
| Oncology Patient Assistance Programs [2295] | $74 | 701% |
| Blue Cross Blue Shield | $74 | 701% |
| Aetna | $74 | 701% |
| Web Tpa [2115] | $74 | 701% |
| Lucent Health [6000] | $74 | 701% |
| Department Of Corrections [1340] | $90 | 852% |
| American Postal Workers Union [1070] | $104 | 985% |
| Cigna | $104 | 985% |
| National Association Of Letter Carriers [1695] | $104 | 985% |
| Healthpartners [1500] | $104 | 985% |
| Humana | $106 | 1004% |
| First Health [1375] | $140 | 1326% |
| American Healthcare [1055] | $140 | 1326% |
| Administrative Concepts [1005] | $140 | 1326% |
| Multiplan [1680] | $140 | 1326% |
| Coventry Healthcare [1320] | $147 | 1392% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel (CPT 80053) at the University of Kansas Health System - St Francis Campus in Topeka, KS, the facility's negotiated rate of $74 is significantly lower than the gross charge of $180, reflecting standard commercial contract dynamics. While the facility's cash price of $54 is the lowest amount listed, patients with high-deductible plans may find paying out-of-pocket initially more cost-effective if their insurance negotiated rate exceeds the cash price, though this depends on individual plan terms. It is important to note that this facility is a voluntary non-profit church-owned acute care hospital, and while the cash rate is competitive, patients should verify their specific deductible status before scheduling to avoid unexpected out-of-pocket costs if their insurance does not cover the service.
The facility's pricing structure aligns closely with state and county averages, as the negotiated rate of $74 matches the lowest and highest values reported across 19 different payers, including major carriers like Aetna, Cigna, and Blue Cross Blue Shield. This consistency suggests a standardized pricing approach across the network, though the Medicare benchmark of $10.56 highlights that commercial rates are substantially higher than the federal baseline. 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 before payment to ensure no unbundled codes or services not rendered are included in the final charge.