Blood test, comprehensive metabolic panel
Facility: Susan B Allen Memorial Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $554
- Cash Discount Price: $26
- vs. Medicare Baseline: 52.46x 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 5246% of the Medicare baseline (a markup of 5146%). 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 |
|---|---|---|
| UnitedHealthcare | $350 | 3314% |
| Providrs Care | $757 | 7169% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel at Susan B Allen Memorial Hospital in El Dorado, KS, the cash median price is $26.00, which is significantly lower than the negotiated rates of $350.00 and $757.00 charged by UnitedHealthcare and Providrs Care, respectively. While commercial insurance contracts often result in higher out-of-pocket costs due to administrative overhead and network tiering, patients with high-deductible plans may find paying the cash price directly more economical if their insurance allowed amount exceeds the cash rate. It is important to note that the facility does not list a specific median paid amount or a negotiated rate against the state average in this dataset, so comparing your specific plan's allowed amount to the $26.00 cash price is the most direct way to determine the best financial option.
To ensure you are receiving the most accurate pricing, always request an itemized bill before finalizing payment, as summary bills can obscure individual line items and potential errors. If you choose to pay out-of-pocket, ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the total cost by offering immediate liquidity incentives. Additionally, remember that Medicare's benchmark rate for this service is $10.56, which serves as a scientifically validated baseline for the true cost of care; commercial rates often exceed this by a significant margin, making the $26.00 cash price a fair and transparent alternative to the inflated negotiated rates listed for insurance payers.