Blood test, comprehensive metabolic panel
Facility: Lane County Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $72
- Cash Discount Price: $72
- vs. Medicare Baseline: 6.82x 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 682% of the Medicare baseline (a markup of 582%). 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 | $65 - $72 | 616% |
| Aetna | $65 - $68 | 616% |
| Medicaid / KanCare | $72 - $79 | 682% |
| Healthy Blue Mcr Adv - All Other Plans | $72 | 682% |
| Healthy Blue Mcaid | $72 | 682% |
| Wppa Providers-All Plans | $108 | 1023% |
Consumer Guidance & Cost Commentary
For the CPT code 80053, representing a comprehensive metabolic panel, Lane County Hospital in Dighton, KS, lists a cash median price of $72.00, which matches the facility's negotiated rate and the gross charge. This price point is notably higher than the state average for this service, which is approximately $10.56 based on Medicare benchmarking. While Medicare serves as the objective baseline for cost, commercial negotiated rates often exceed these benchmarks due to administrative overhead and contract dynamics. Patients should be aware that paying cash directly can sometimes be more cost-effective than using insurance if the negotiated rate exceeds the cash price, particularly for those with high-deductible plans who may face significant out-of-pocket costs before coverage kicks in.
It is important to verify your specific plan details before scheduling, as insurance companies negotiate different rates, and some in-network facilities may charge significantly more than others. For this specific test, the median amount paid by payers is $68.00, while the highest negotiated rate listed is $108.00. If you choose to pay out-of-pocket, you should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid upfront. Additionally, ensure you request an itemized billing audit to confirm that all charges are accurate and that no services were rendered but billed, as over 80% of hospital bills contain errors that can be corrected through a formal written dispute.