Blood test, comprehensive metabolic panel
Facility: Cheyenne County Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $32
- Cash Discount Price: $34
- vs. Medicare Baseline: 3.03x 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 303% of the Medicare baseline (a markup of 203%). 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 | $4 - $34 | 38% |
| Blue Cross Blue Shield | $22 | 208% |
| Choice Care - All Plans | $24 | 227% |
| Healthy Blue Mcr Adv | $24 | 227% |
| First Health - All Plans | $24 | 227% |
| Aetna | $24 - $32 | 227% |
| Tricare | $24 | 227% |
| Firstguard - All Plans | $27 | 256% |
| Wppa - All Plans | $30 | 284% |
| Preferred Hc - All Plans | $32 | 303% |
| Cpm - All Plans | $32 | 303% |
| Health Partners - All Plans | $33 | 313% |
| Unicare - All Plans | $33 | 313% |
| Ppo Next - All Plans | $33 | 313% |
| Integrated Hp - All Plans | $33 | 313% |
| Midlands Choice - All Plans | $33 | 313% |
| Healthwave Mcaid - All Plans | $34 | 322% |
| Childrens Mercy - All Plans | $34 | 322% |
| Healthy Blue Mcaid - All Other Plans | $34 | 322% |
| Providers Care-All Plans | $51 | 483% |
Consumer Guidance & Cost Commentary
For this comprehensive metabolic panel at Cheyenne County Hospital, the cash price is $34.00, which matches the facility's negotiated rate of $32.00 and the median paid amount of $29.00. While the facility is in-network for most payers, the cash price is notably lower than the gross charge of $34.00 and aligns closely with the state average for this service. Patients with high-deductible plans may find paying the cash price upfront more beneficial than relying on insurance, as the negotiated rate of $32.00 exceeds the cash price, and the facility offers prompt-pay discounts for upfront payment. It is important to request self-pay classification and a waiver of insurance submission before check-in to ensure these cash rates apply rather than triggering standard claim processing.
The Medicare benchmark for this procedure is $10.56, which serves as a baseline for evaluating the facility's pricing structure. The cash price of $34.00 represents a significant markup over the Medicare rate, reflecting the administrative costs and profit margins inherent in commercial billing. However, the facility's negotiated rate of $32.00 and the median paid amount of $29.00 suggest that commercial contracts are keeping prices relatively close to the cash price, unlike many other in-network scenarios where allowed amounts can be substantially higher. To avoid unexpected costs, patients should verify their specific plan's allowed amount and consider requesting an itemized bill to confirm that no unbundled codes or services not rendered are included in the final charge.