Blood test, comprehensive metabolic panel
Facility: Kansas City Orthopaedic Institute
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $52
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 4.92x 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 492% of the Medicare baseline (a markup of 392%). 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 - $88 | 104% |
| UnitedHealthcare | $11 - $103 | 104% |
| Aetna | $11 | 104% |
| Blue Cross Blue Shield | $20 - $113 | 189% |
| Medica | $92 - $97 | 871% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel (CPT 80053) at Kansas City Orthopaedic Institute in Leawood, KS, the facility's negotiated rates range from $11 to $113 across five major payers, with a median negotiated payment of $52.00. While the facility is owned by physicians and located in an acute care hospital setting, the data does not provide specific cash or state/county average figures for this procedure. Without direct comparison data to the local average, patients cannot yet determine if this facility's pricing is above or below the regional norm. However, it is important to note that cash-pay options are often not listed in this report; if the patient's insurance deductible has not been met, paying the full negotiated rate could be significantly higher than the actual cost of the service.
Patients should be aware that commercial insurance rates often include administrative overhead and contractual markups that can exceed the true cost of care. Although the report does not list a specific cash price, patients with high-deductible plans should inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid upfront. Additionally, if a patient receives care from an out-of-network provider at this facility, they may be subject to balance billing for the difference between the allowed amount and the full chargemaster rate, though the No Surprises Act protects against such billing for emergency and non-emergency services at in-network facilities. To ensure accuracy, patients should request a detailed, itemized bill to verify that all charges correspond to services actually rendered and to identify any potential errors before finalizing payment.