Blood test, comprehensive metabolic panel
Facility: Stormont Vail Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $19
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.80x 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.
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 | $11 | 104% |
| Blue Cross Blue Shield | $11 - $23 | 104% |
| Ambetter / Centene | $11 | 104% |
Consumer Guidance & Cost Commentary
For this comprehensive metabolic panel test at Stormont Vail Hospital in Topeka, KS, the insurance negotiated rate is $19.00, which is significantly higher than the facility's cash price of $11.00. While commercial insurance plans like UnitedHealthcare, Blue Cross Blue Shield, and Ambetter / Centene pay this negotiated amount, patients with high-deductible plans may find it more cost-effective to pay the cash price directly, as the insurance rate exceeds the cash rate. It is important to note that commercial rates often include administrative overhead and contract dynamics that push prices well above the actual cost of care, making the cash option a potential savings strategy for those who can afford it.
The facility's pricing is also evaluated against federal benchmarks; the Medicare amount for this service is $10.56, meaning the negotiated rate represents a markup of 1.8 times the Medicare standard. Although the facility is a voluntary non-profit with a strong rating of 4, patients should be aware that the $19.00 negotiated rate is not the lowest possible price available. To maximize savings, individuals should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing costly insurance billing cycles. Additionally, since over 80% of hospital bills contain errors, patients should always request a full itemized bill to verify that no services were double-billed or unbundled before making any payment.