Blood test, comprehensive metabolic panel
Facility: Kansas Medical Center Llc
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $11
- Cash Discount Price: $57
- 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 |
|---|---|---|
| United | $5 | 47% |
| Indian Health | $10 | 95% |
| Blue Cross Blue Shield | $11 | 104% |
| Humana | $11 | 104% |
| Medicaid / KanCare | $11 | 104% |
| Medadv_Wellcare | $11 | 104% |
| Ambetter / Centene | $11 | 104% |
| Three_Rivers | $21 | 199% |
| Wppa | $28 - $48 | 265% |
| Aetna | $33 | 313% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel at Kansas Medical Center Llc in Andover, KS, the cash median price is $57.00, which is lower than the facility's negotiated rate of $89.00. While the facility's negotiated rate is significantly higher than the Medicare benchmark of $10.56, patients with high-deductible plans may find paying cash directly more cost-effective if their insurance negotiated rate exceeds the cash price. It is important to note that the facility's cash rate does not appear to align with typical state or county averages for this service, suggesting that direct payment could result in substantial savings compared to standard insurance billing structures.
Commercial insurance carriers in this region, including United, Blue Cross Blue Shield, and Humana, negotiate rates that average $11.00, which is still more than double the Medicare amount. However, because commercial contracts often include administrative overhead and multi-layered pricing dynamics, the actual amount a patient pays can vary widely depending on their specific plan and deductible status. To minimize costs, patients should verify their deductible balance before scheduling and explicitly request "self-pay" or "prompt-pay" discounts from the billing department, as these upfront payment incentives can bypass the higher administrative costs associated with insurance claims processing.