Blood test, comprehensive metabolic panel
Facility: Centura St. Catherine-Dodge City
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $104
- Cash Discount Price: $63
- vs. Medicare Baseline: 9.85x 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 985% of the Medicare baseline (a markup of 885%). 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 |
|---|---|---|
| Cigna | $11 | 104% |
| Aetna | $11 - $126 | 104% |
| Blue Cross Blue Shield | $11 - $27 | 104% |
| Humana | $11 | 104% |
| Kansas Health | $11 | 104% |
| Medicare (plans) | $11 | 104% |
| Kaiser | $11 | 104% |
| Centura Employee Plan | $13 | 123% |
| UnitedHealthcare | $104 | 985% |
| Wpaa | $110 | 1042% |
| Christian Health Aid | $126 | 1193% |
| Multiplan | $126 - $142 | 1193% |
| Health Partners Of Kansas | $142 | 1345% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel (CPT 80053) at Centura St. Catherine-Dodge City, the facility's cash median price of $63.00 is significantly lower than the state average of $104.00 and the Medicare benchmark of $10.56. While commercial payers like UnitedHealthcare and Multiplan have negotiated rates ranging from $104 to $142, these amounts often exceed the cash price, making self-pay a potentially more economical option for patients with high-deductible plans. Because hospitals frequently offer prompt-pay discounts for upfront payment, patients should verify if a reduced rate is available before scheduling, as paying the full negotiated amount without meeting a deductible can result in higher out-of-pocket costs than paying cash directly.
It is important to distinguish between the facility's gross charge of $158.00 and the actual amounts paid by insurers, which vary widely across the 13 participating plans. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still request an itemized bill to ensure no unbundled codes or services not rendered are included. Given that over 80% of hospital bills contain errors, reviewing the line-by-line statement is a critical step to identify discrepancies and avoid unnecessary debt. If a patient receives a bill that appears higher than the cash or negotiated rates, they should dispute the charges in writing rather than accepting summary invoices, as these often obscure the true cost of care.