Blood test, comprehensive metabolic panel
Facility: Wesley Medical Center
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $22
- Cash Discount Price: $1,429
- vs. Medicare Baseline: 2.08x 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 208% of the Medicare baseline (a markup of 108%). 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 |
|---|---|---|
| Humana | $11 | 104% |
| UnitedHealthcare | $11 | 104% |
| Devoted Health | $11 | 104% |
| Amerigroup | $11 | 104% |
| Triwest Health Alliance | $11 | 104% |
| Coventry Health Care | $11 | 104% |
| Aetna | $11 - $510 | 104% |
| Medicaid / KanCare | $11 | 104% |
| Ambetter / Centene | $11 - $257 | 104% |
| United | $11 - $643 | 104% |
| Blue Cross Blue Shield | $13 | 123% |
| Correct Care Solutions | $16 | 152% |
| First Health | $22 - $659 | 208% |
| Multiplan | $23 - $1,286 | 218% |
| Health Partners Of Kansas | $247 - $714 | 2339% |
| Wppa | $249 | 2358% |
| Medical Associates Health Plan | $270 | 2557% |
| Preferred Health Choices | $270 | 2557% |
| Spirit Aerosystems | $457 | 4328% |
| Triwest Healthcare Alliance | $929 | 8797% |
| Usa Managed Care | $1,215 | 11506% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel (CPT 80053) at Wesley Medical Center in Wichita, KS, the cash price is $1,429.00, which matches the facility's median negotiated rate. This cash price is significantly higher than the state average, reflecting the specific cost structure of this acute care hospital. While commercial insurance plans like Aetna and United may negotiate rates as high as $643 or $1,215 respectively, these figures often include administrative overhead and do not represent the lowest possible cost for the patient. For individuals with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price directly can sometimes be more economical than relying on insurance, especially if the insurer's negotiated rate exceeds the cash amount.
Patients should proactively contact the hospital's billing department to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid upfront. It is important to verify that any insurance payment is actually applied to your deductible, as some plans may bill the full negotiated rate even if you have not yet met your coverage threshold. Additionally, while the No Surprises Act protects patients from balance billing for emergency care and non-emergency services at in-network facilities, unexpected charges can still occur if ancillary services are out-of-network. We recommend requesting a full, itemized bill before finalizing payment to ensure no errors or unbundled codes are included, as over 80% of hospital bills contain discrepancies that can be resolved through a formal audit.