Blood test, comprehensive metabolic panel
Facility: Kearny County Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $277
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 26.23x 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 2623% of the Medicare baseline (a markup of 2523%). 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 |
|---|---|---|
| Kansas Solutions | $277 | 2623% |
| Wps Gha - Mac J5 Part A | $277 - $554 | 2623% |
| Humana | $277 | 2623% |
| UnitedHealthcare | $277 | 2623% |
| Meritain Health | $277 | 2623% |
| Luminare Health | $277 | 2623% |
| Cigna | $277 | 2623% |
| Pan-American Life Insurance Co | $277 | 2623% |
| Blue Cross Blue Shield | $277 - $554 | 2623% |
| Aetna | $277 | 2623% |
| Community Care Health Plan Of | $277 | 2623% |
| American Health Plans | $277 | 2623% |
Consumer Guidance & Cost Commentary
For this comprehensive metabolic panel at Kearny County Hospital in Lakin, KS, the negotiated rates range from $277 to $554 across 12 insurance payers, with a median negotiated amount of $277. This rate is significantly higher than the facility's median paid amount of $222.00, indicating that insurance companies are paying less than the contracted rate for this service. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that cash-pay options may offer savings; if your insurance deductible is high or you have a high-deductible plan, paying the cash price directly could result in lower out-of-pocket costs compared to your insurance's negotiated rate. It is always advisable to ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling to ensure you are not overpaying for the test.
The Medicare benchmark for this procedure is $10.56, which serves as the objective baseline for evaluating pricing markups. The facility's negotiated rates are substantially higher than this federal rate, reflecting the administrative costs and contract dynamics inherent in commercial insurance billing. Because over 80% of hospital bills contain errors, patients should request a full itemized CPT-coded bill rather than accepting a summary invoice, which may obscure unbundled charges or services not rendered. If you receive a balance bill for out-of-network ancillary services at this in-network facility, you may be entitled to protections under the No Surprises Act, and you should dispute any unexpected charges in writing rather than paying immediately to avoid credit damage.