Blood test, comprehensive metabolic panel
Facility: St. Catherine Hospital - Garden City
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $37
- Cash Discount Price: $98
- vs. Medicare Baseline: 3.50x 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 350% of the Medicare baseline (a markup of 250%). 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 | $10 - $129 | 95% |
| Innovage | $10 | 95% |
| Medicare (plans) | $10 | 95% |
| Kaiser | $10 - $77 | 95% |
| Devoted Health | $10 | 95% |
| Aetna | $10 - $176 | 95% |
| Humana | $10 | 95% |
| Kansas Health | $10 | 95% |
| Blue Cross Blue Shield | $10 - $37 | 95% |
| Cigna | $10 - $14 | 95% |
| Centura Employee Plan | $13 | 123% |
| United Colorado Doctor'S Plan | $16 | 152% |
| Direct To Employer | $18 - $112 | 170% |
| Denver Health | $66 | 625% |
| Peak Health | $109 | 1032% |
| Wpaa | $146 | 1383% |
| Christian Health Aid | $167 | 1581% |
| Multiplan | $188 - $238 | 1780% |
| Health Partners Of Kansas | $203 | 1922% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel (CPT 80053) at St. Catherine Hospital in Garden City, KS, the facility's cash price of $98.00 is significantly higher than the state average of $11.00 and the county average of $37.00. While commercial insurance plans like UnitedHealthcare and Aetna negotiate rates ranging from $10 to $176, these negotiated amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying the full cash price upfront. To secure the lowest possible rate, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as paying in full can sometimes bypass the higher administrative costs embedded in insurance billing cycles.
It is important to understand that the facility's gross charge of $245.00 represents the maximum list price, not the amount you will pay. Commercial payers negotiate rates that act as a ceiling, but these rates frequently include administrative overhead and do not reflect the true cost of care, which is better benchmarked against the Medicare rate of $10.56. Since Medicare rates are calculated based on actual provider costs plus a small margin, they serve as a more accurate baseline for evaluating pricing markups than the hospital's inflated chargemaster. If you receive a bill that appears to include charges for services not rendered or unbundled components, you should request a detailed, itemized audit to identify errors before paying, as over 80% of hospital bills contain mistakes that can be corrected.