Blood test, comprehensive metabolic panel
Facility: Wichita County Health Center
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $76
- Cash Discount Price: $72
- vs. Medicare Baseline: 7.20x 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 720% of the Medicare baseline (a markup of 620%). 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 |
|---|---|---|
| Medicaid / KanCare | $16 - $132 | 152% |
| UnitedHealthcare | $20 - $160 | 189% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel (CPT 80053) at Wichita County Health Center in Leoti, KS, the facility's cash median rate of $72.00 is notably lower than the state average of $74.00 and the median negotiated rate of $76.00. While Medicaid/KanCare plans pay a low of $16.00 to a high of $132.00, and UnitedHealthcare ranges from $20.00 to $160.00, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $72.00. Because the facility is a Critical Access Hospital owned by the local government, it is important to verify specific self-pay or prompt-pay discounts before scheduling, as these upfront payment incentives can further reduce the final amount owed.
When evaluating costs, it is essential to compare these rates against the Medicare benchmark of $10.56, which serves as the objective baseline for fair pricing. The facility's cash rate represents a significant markup over this federal standard, illustrating how commercial pricing structures often differ from the true cost of care. If you receive a bill from this provider, you should request a full itemized statement to ensure no errors exist, as over 80% of hospital bills contain mistakes such as double-billing or unbundled codes. Additionally, if you are out-of-network, the No Surprises Act protects you from balance billing for emergency services, but you should still dispute any unexpected charges in writing rather than paying immediately out of fear of credit damage.