Blood test, comprehensive metabolic panel
Facility: Rawlins County Health Center
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $61
- Cash Discount Price: $68
- vs. Medicare Baseline: 5.78x 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 578% of the Medicare baseline (a markup of 478%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $23 | 218% |
| UnitedHealthcare | $61 - $78 | 578% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel service (CPT 80053) at Rawlins County Health Center in Atwood, Kansas, the cash price is $68.00, which is lower than the facility's negotiated rates with UnitedHealthcare ($61.00 to $78.00) and Blue Cross Blue Shield ($23.00). While the cash price is notably lower than the negotiated rates for UnitedHealthcare, it is important to note that commercial negotiated rates often include administrative overhead and may exceed the cash price for patients with high-deductible plans. Medicare sets the benchmark for this service at $10.56, and the facility's cash rate is approximately 6.2 times higher than this federal baseline. Patients should verify their specific plan's deductible status before relying on insurance, as paying the full negotiated amount out-of-pocket could be more expensive than paying cash directly, especially if the insurance allowed amount is high.
To ensure you are not overcharged, it is recommended to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. If you receive a surprise bill for out-of-network services, you may have protections under the No Surprises Act, which bans balance billing for emergency care and non-emergency services at in-network facilities. Additionally, ask the hospital about "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if you pay in full upfront, bypassing the costly insurance claims processing cycle. Always confirm whether the facility offers a self-pay discount prior to scheduling your visit to ensure you are utilizing the most