Blood test, comprehensive metabolic panel
Facility: Kansas Heart Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $11
- Cash Discount Price: $24
- 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 | $4 | 38% |
| Tricare | $10 | 95% |
| Celtic Mcr Adv | $11 | 104% |
| Medicaid / KanCare | $11 | 104% |
| Humana | $11 | 104% |
| UnitedHealthcare | $11 | 104% |
| Wppa - All Plans | $15 | 142% |
| Blue Cross Blue Shield | $15 | 142% |
| Multiplan - All Plans | $34 | 322% |
Consumer Guidance & Cost Commentary
For the CPT code 80053, representing a comprehensive metabolic panel blood test, Kansas Heart Hospital in Wichita, KS, lists a cash median price of $24.00 and a median negotiated rate of $11.00. While the facility's negotiated rate is lower than its cash price, patients should be aware that commercial insurance contracts often include administrative overheads that can inflate the final allowed amount. It is important to verify your specific plan's deductible status before scheduling, as paying the full negotiated rate may not be covered if you have not yet met your out-of-pocket threshold. Additionally, if your insurance company's allowed amount exceeds the cash price of $24.00, paying out-of-pocket might result in a lower total cost for you, provided you can secure a "self-pay" or "prompt-pay" discount by paying the bill upfront.
This service is benchmarked against the federal Medicare rate of $10.56, which serves as a scientifically validated baseline for the true cost of care. The facility's cash price of $24.00 is approximately 2.26 times the Medicare rate, reflecting the standard markup found in commercial healthcare pricing. Patients should avoid comparing these costs against the hospital's gross chargemaster list, as those figures are inflated to make discounts appear larger than they are. If you receive a bill that includes unexpected charges for out-of-network ancillary services, you have the right to dispute it under the No Surprises Act, but for this specific in-network test, the primary focus should remain on confirming your coverage details and asking the billing department about any available prompt-pay incentives to minimize your financial responsibility.