Blood test, comprehensive metabolic panel
Facility: Lmh
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $11
- Cash Discount Price: $99
- vs. Medicare Baseline: 1.04x 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 | $10 - $46 | 95% |
| Blue Cross Blue Shield | $10 - $256 | 95% |
| Allwell | $11 | 104% |
| Humana | $11 | 104% |
| Cigna | $11 - $265 | 104% |
| Haskell Indian Health Services | $11 | 104% |
| Medicare (plans) | $11 | 104% |
| Aetna | $12 - $329 | 114% |
| Ambetter / Centene | $16 | 152% |
| Non Contracted | $317 | 3002% |
| First Health | $368 | 3485% |
Consumer Guidance & Cost Commentary
For this comprehensive metabolic panel test, the facility's cash price of $99.00 is significantly lower than the negotiated rates charged by most major insurers, which range from $10 to $368 depending on the plan. While the facility is in-network for many payers, the data indicates that commercial negotiated rates often exceed the cash price, meaning patients with high-deductible plans might save money by paying the cash rate directly. It is important to note that the facility's cash rate is also lower than the state average for this service, and the Medicare benchmark of $10.56 serves as a baseline for fair pricing, suggesting that the cash rate is already well-aligned with cost-based standards.
To minimize potential balance billing or unexpected charges, patients should verify their specific plan's allowed amount before scheduling, as some out-of-network services or ancillary tests could trigger different billing structures. If you choose to pay out-of-pocket, ask the billing department about "self-pay" or "prompt-pay" discounts, which can further reduce the $99.00 cash price. 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 dispute.