Blood test, comprehensive metabolic panel
Facility: Grisell Memorial Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $32
- Cash Discount Price: $54
- vs. Medicare Baseline: 3.03x 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 303% of the Medicare baseline (a markup of 203%). 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 |
|---|---|---|
| UnitedHealthcare | $6 - $42 | 57% |
| Blue Cross Blue Shield | $21 | 199% |
| Humana | $56 | 530% |
| Medicaid / KanCare | $56 | 530% |
Consumer Guidance & Cost Commentary
For this comprehensive metabolic panel at Grisell Memorial Hospital in Ransom, KS, the negotiated rates for UnitedHealthcare and Blue Cross Blue Shield range from $21 to $42, while Humana and Medicaid/KanCare pay the full list price of $56. This facility is a Critical Access Hospital owned by a government hospital district, and the cash median price is $54.00, which is slightly lower than the negotiated rates for most payers. Because commercial insurance contracts often include administrative overhead and multi-layered pricing structures, the cash price can sometimes be cheaper for patients with high-deductible plans if their insurance negotiated rate exceeds the cash price. It is important to check with the hospital directly for "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
When evaluating the cost of this service, it is essential to compare rates against the Medicare benchmark rather than the hospital's gross chargemaster list. The Medicare amount for this code is $10.56, and the facility's negotiated rates are significantly higher, reflecting the standard markup found in commercial contracts. Patients should be aware that balance billing can occur if they receive care from out-of-network providers, though the No Surprises Act protects against surprise bills for emergency services and non-emergency services at in-network facilities. If you receive a bill that seems unexpectedly high, request a formal itemized audit to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes that can be corrected through a written dispute.