Blood test, comprehensive metabolic panel
Facility: Providence Medical Center
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $11
- Cash Discount Price: $10
- 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 |
|---|---|---|
| Kansas Superior Select | $11 | 104% |
| UnitedHealthcare | $11 - $17 | 104% |
| Celtic | $11 - $17 | 104% |
| Cigna | $11 | 104% |
| Aetna | $11 - $18 | 104% |
| Medicaid / KanCare | $11 | 104% |
| Tricare | $11 | 104% |
| Medicare (plans) | $11 | 104% |
| Blue Cross Blue Shield | $11 - $25 | 104% |
| Healthy Blue | $11 | 104% |
| Midland Care Connection | $11 | 104% |
| Corizon | $14 | 133% |
| Employer Direct Healthcare | $15 | 142% |
| Well Path Prison | $15 | 142% |
| Centurion | $16 | 152% |
| Naphcare | $16 | 152% |
| Comp Alliance - Fka Compresults Worker Compensation | $21 | 199% |
| Worker Compensation | $23 | 218% |
| Oha Networks | $23 | 218% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel (CPT 80053) at Providence Medical Center in Kansas City, KS, the facility's cash median price is $10.00, which is significantly lower than the state average of $293.00. While commercial insurance plans like UnitedHealthcare and Aetna negotiate rates ranging from $11 to $25, these negotiated amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket and seeking prompt-pay discounts before services are rendered. Because commercial rates include administrative overhead and contract markups, the cash price serves as a useful benchmark to determine if your specific insurance plan is actually providing a lower cost than paying directly.
It is important to note that Medicare, which acts as a cost-basis standard for fair pricing, sets the benchmark at $10.56, aligning closely with the facility's cash rate and far below the commercial negotiated rates. If you receive a bill that includes charges higher than the Medicare benchmark or the cash price, you may be subject to balance billing if you are out-of-network, though the No Surprises Act protects you from such surprise bills for emergency care and non-emergency services at in-network facilities. To ensure you are not overcharged, always request an itemized bill to verify that all services were rendered and that no unbundled codes or unnecessary items are included, and do not accept summary bills as the final invoice without reviewing the detailed line items.