Blood test, comprehensive metabolic panel
Facility: Jewell County Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $154
- Cash Discount Price: $122
- vs. Medicare Baseline: 14.58x 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 1458% of the Medicare baseline (a markup of 1358%). 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 |
|---|---|---|
| Rural Carriers - All Plans | $138 | 1307% |
| Aetna | $146 | 1383% |
| Meritain - All Plans | $146 | 1383% |
| Midlands Choice - All Plans | $154 | 1458% |
| First Health - All Plans | $154 | 1458% |
| UnitedHealthcare | $154 | 1458% |
| Cigna | $154 | 1458% |
Consumer Guidance & Cost Commentary
For this comprehensive metabolic panel test at Jewell County Hospital in Mankato, KS, the negotiated rates paid by major insurers like Aetna, Cigna, and UnitedHealthcare are $154, which matches the facility's median negotiated amount. While these in-network rates provide financial protection against surprise billing, they are notably higher than the cash price of $122. Patients with high-deductible plans or those without insurance may find it beneficial to pay the cash price directly, as this avoids the administrative markup inherent in insurance billing cycles. It is important to note that while the facility is a Critical Access Hospital owned by the local government, commercial payers often negotiate rates that exceed the cash option due to the costs of claims processing and contract management.
The Medicare benchmark for this service is $10.56, which serves as a baseline for evaluating the facility's pricing structure. Although the data does not provide specific county or state averages for comparison, the significant difference between the Medicare rate and the commercial negotiated rate highlights the typical markup found in healthcare pricing. To ensure you are receiving the best possible rate, we recommend asking the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront. Additionally, if you have received a bill after using insurance, request a full itemized statement to verify that no balance billing or unbundled charges have occurred, as federal protections like the No Surprises Act may apply depending on the specific services rendered.