Blood test, comprehensive metabolic panel
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $11
- Cash Discount Price: $86
- 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 |
|---|---|---|
| Aetna | $11 | 104% |
| Medicare (plans) | $11 | 104% |
| Humana | $11 | 104% |
| Providrs Care | $11 | 104% |
| Medicaid / KanCare | $11 | 104% |
| Va | $11 | 104% |
| UnitedHealthcare | $11 - $30 | 104% |
| Smarthealth | $15 | 142% |
| Ambetter / Centene | $18 | 170% |
| Blue Cross Blue Shield | $121 - $260 | 1146% |
Consumer Guidance & Cost Commentary
For this comprehensive metabolic panel test at Ascension Via Christi Hospital in Manhattan, KS, the facility's cash price of $86.00 is significantly lower than the negotiated rates charged by most commercial insurers, which range from $11.00 to $260.00 depending on the plan. While the facility's negotiated rate of $11.00 appears low, it is important to note that commercial insurance contracts often include administrative overheads that can inflate the final allowed amount, and patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance reimbursement that could exceed the cash rate. The facility's cash price is also notably higher than the Medicare benchmark of $10.56, which serves as the federal baseline for true cost, suggesting that while the cash option is a strong value, the commercial negotiated rates vary widely across the 10 payer plans represented here.
Patients should proactively contact the hospital before scheduling to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can further reduce the final bill by bypassing costly claims processing fees. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to request an itemized bill to ensure no unbundled charges or services not rendered are included, as over 80% of hospital bills contain errors. By comparing the facility's pricing against the Medicare benchmark and verifying the specific allowed amounts for your plan, you can make an informed decision that avoids unexpected costs and potential administrative pitfalls.