Blood test, comprehensive metabolic panel
Facility: Overland Park Reg Med Ctr
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $231
- Cash Discount Price: $1,302
- vs. Medicare Baseline: 21.88x 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 2188% of the Medicare baseline (a markup of 2088%). 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 | $5 - $11 | 47% |
| Home State Health Plan | $10 | 95% |
| Blue Cross Blue Shield | $10 - $586 | 95% |
| Aetna | $10 - $696 | 95% |
| Coventry | $10 - $548 | 95% |
| United | $10 - $614 | 95% |
| Devoted Health | $11 | 104% |
| Triwest Health Alliance | $11 | 104% |
| Humana | $11 - $26 | 104% |
| Celtic | $11 | 104% |
| Pyramid Life | $11 | 104% |
| Unicare | $11 | 104% |
| Healthyblue | $11 | 104% |
| Medicaid / KanCare | $11 | 104% |
| Amerigroup | $11 | 104% |
| Wellcare | $11 | 104% |
| Oscar | $16 | 152% |
| Multiplan | $19 - $1,009 | 180% |
| Corvel Corporation | $22 - $886 | 208% |
| Oha Network | $23 - $682 | 218% |
| Ambetter / Centene | $231 - $254 | 2188% |
| Nhc Advantage | $236 - $259 | 2235% |
| Wppa Providrs Care Network | $248 - $273 | 2348% |
| Universal Healthcare | $434 - $477 | 4110% |
| Coventry Kc Mo | $508 - $559 | 4811% |
| College Park Family Care Center | $533 - $586 | 5047% |
| Cco, Inc. | $930 - $1,023 | 8807% |
| Focus Healthcare Mgmt, Inc | $930 - $1,023 | 8807% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel (CPT 80053) at Overland Park Reg Med Ctr, the cash price is $1,302.00, which matches the facility's cash median. This rate is significantly higher than the state average, as indicated by a 21.9% variance versus Medicare. While commercial insurance contracts often result in negotiated rates that can exceed cash prices due to administrative overhead and multi-layered billing structures, patients with high-deductible plans may find paying out-of-pocket cheaper if the insurer's allowed amount surpasses the cash rate. It is important to note that while the facility is an in-network provider for many plans, specific services like laboratory tests can sometimes be billed at out-of-network rates, potentially triggering balance billing unless protected by the No Surprises Act for non-emergency services at in-network facilities.
The facility offers a median negotiated rate of $231.00 across 28 payers, though this figure varies widely depending on the specific insurance plan and contract terms. For example, while some payers like Cigna and Home State Health Plan have negotiated rates between $5 and $11, others such as Multiplan and Corvel Corporation have rates ranging from $19 to $1,009. To minimize costs, patients should request a prompt-pay discount before scheduling, which can reduce the bill by 20% to 50% for upfront payment. Additionally, if you receive a summary bill, you should demand a full itemized audit to identify errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies that can be corrected through a formal written dispute.