Blood test, comprehensive metabolic panel
Facility: Pratt Regional Medical Center
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $27
- Cash Discount Price: $23
- vs. Medicare Baseline: 2.56x 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 256% of the Medicare baseline (a markup of 156%). 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 |
|---|---|---|
| Christian Health Aid | $13 - $36 | 123% |
| UnitedHealthcare | $14 - $49 | 133% |
| Health Partners Of Kansas | $14 - $41 | 133% |
| Aetna | $15 - $43 | 142% |
| Choicecare | $17 - $48 | 161% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel (CPT 80053) at Pratt Regional Medical Center in Pratt, Kansas, the cash median price is $23.00, which is lower than the facility's negotiated rates ranging from $13 to $48 across five payers including UnitedHealthcare and Aetna. This facility is located in a rural area where the state average for this service is $23.00, meaning the cash price aligns exactly with the state baseline. While the Medicare benchmark for this procedure is $10.56, the cash rate represents a 2.6x markup relative to that federal standard. Patients with high-deductible plans may find it financially advantageous to pay the $23.00 cash price directly, as this avoids the administrative overhead and higher negotiated rates that commercial insurers typically charge, which often exceed the cash amount due to multi-layered billing structures.
To secure the lowest possible cost, patients should proactively contact the hospital to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can further reduce the bill by bypassing costly claims processing. It is important to verify your insurance status before scheduling, as assuming that being in-network guarantees the best price is a common pitfall; in this case, the negotiated rates for in-network plans start at $13 but can reach $48, significantly higher than the cash option. Additionally, if you receive an itemized bill, request a full line-by-line audit to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written dispute.