Blood test, comprehensive metabolic panel
Facility: Mercy Hospital Columbus
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $117
- Cash Discount Price: $105
- vs. Medicare Baseline: 11.08x 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 1108% of the Medicare baseline (a markup of 1008%). 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 |
|---|---|---|
| Centivo Contracted [320505] | $2 | 19% |
| Medicaid / KanCare | $9 - $117 | 85% |
| Humana | $9 - $153 | 85% |
| UnitedHealthcare | $10 - $134 | 95% |
| Blue Cross Blue Shield | $10 - $117 | 95% |
| Medicare (plans) | $11 - $122 | 104% |
| Health Systems Inc Contracted [320174] | $69 | 653% |
| Insurance System Inc Contracted [320465] | $69 | 653% |
| Administrative Payor Contracted [320005] | $72 | 682% |
| Cross Timbers Hospice [20098] | $117 | 1108% |
| Ambetter / Centene | $117 | 1108% |
| Novasys Contracted [320285] | $117 | 1108% |
| Elara Caring Aspire Hospice [20433] | $117 | 1108% |
| Centurion Of Missouri [20459] | $117 | 1108% |
| Medical Associates Health Contracted [320444] | $117 | 1108% |
| Dept Of Veteran Affairs Contracted [320106] | $117 | 1108% |
| Halo Hcr Inc Hospice Contracted [320432] | $117 | 1108% |
| Halo Hcr Inc Hospice [20432] | $117 | 1108% |
| Cigna | $117 | 1108% |
| Kindful Hospice [20434] | $117 | 1108% |
| Pace Of The Ozarks Contracted [320518] | $117 | 1108% |
| Qual Choice Contracted [320325] | $117 | 1108% |
| Aetna | $117 - $145 | 1108% |
| Provider Partners Health Plans Contracted [320450] | $117 | 1108% |
| Cherokee Nation Health Serv Contracted [320066] | $117 | 1108% |
| Tricare | $117 | 1108% |
| Mercy Mgd Behavioral Health Contracted [320259] | $117 | 1108% |
| Home State Health Plan Contracted [320187] | $117 | 1108% |
| Indian Health Service Contracted [320198] | $117 | 1108% |
| Mercy Hospice Okc [20252] | $117 | 1108% |
| Kindful Hospice Contracted [320434] | $117 | 1108% |
| Globalhealth Contracted [320145] | $117 | 1108% |
| Healthscope Contracted [320182] | $124 | 1174% |
| Workers Comp [20426] | $129 - $137 | 1222% |
| United Medical Resources Contracted [320454] | $134 - $153 | 1269% |
| Medica Contracted [320239] | $144 | 1364% |
| Preferred Health Plan Contracted [320522] | $145 | 1373% |
| Healthlink Contracted [320179] | $145 - $153 | 1373% |
| Federal Medical Center Contracted [320127] | $145 | 1373% |
| Usa Managed Care Org Contracted [320429] | $145 | 1373% |
| American Healthcare Alliance Contracted [320020] | $145 | 1373% |
| Mercy Benefit Admin Contracted [320251] | $145 - $153 | 1373% |
| First Health Contracted [320128] | $145 | 1373% |
| Auxiant Contracted [320462] | $153 | 1449% |
| Reflect Health Contracted [320492] | $153 | 1449% |
| Benefit Management Contracted [320052] | $153 | 1449% |
| Ebms Contracted [320493] | $153 | 1449% |
| Imagine 360 Contracted [320494] | $153 | 1449% |
| Aither Health Contracted [320449] | $153 | 1449% |
| Private Health Care Systems Contracted [320320] | $153 | 1449% |
| Show-Me Health Administrators Contracted [320483] | $153 | 1449% |
| Point C Contracted [320238] | $153 | 1449% |
| Ppo Plus Contracted [320310] | $153 | 1449% |
| Edison Health Solutions Contracted [320502] | $153 | 1449% |
| 90 Degree Benefits Contracted [320436] | $153 | 1449% |
| Yuzu Health Contracted [320521] | $153 | 1449% |
Consumer Guidance & Cost Commentary
For this comprehensive metabolic panel test at Mercy Hospital Columbus, the facility's cash price of $105.00 is notably lower than the state average of $140.00, offering a potential savings of $35.00 for patients paying out-of-pocket. While many insurance plans negotiate a standard rate of $117.00, which is higher than the cash price, patients with high-deductible plans may find it financially advantageous to pay the cash rate directly, provided they have sufficient funds. It is important to note that the facility's negotiated rates for various payers, such as Medicaid and Humana, range from $2 to $153, reflecting the complex dynamics of insurance contracts that often include administrative overheads not present in direct cash transactions.
To maximize savings, patients should proactively contact the hospital's billing department to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront. Additionally, since Medicare sets a benchmark rate of $10.56 for this service, the commercial negotiated rates are significantly higher, highlighting the substantial markup inherent in insurance billing structures. Consumers are advised to request a detailed, itemized bill before scheduling any services to ensure accuracy and avoid unexpected charges, as summary bills often obscure the true cost of individual components.