Blood test, comprehensive metabolic panel
Facility: F W Huston Medical Center
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $116
- Cash Discount Price: $120
- vs. Medicare Baseline: 10.98x 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 1098% of the Medicare baseline (a markup of 998%). 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% |
| Aetna | $112 | 1061% |
| Humana | $118 | 1117% |
| Cigna | $128 | 1212% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel at F W Huston Medical Center in Winchester, KS, the cash price of $120.00 is notably lower than the facility's negotiated rates, which range from $112.00 to $118.00 across four major payers including Aetna, Blue Cross Blue Shield, Humana, and Cigna. This pricing structure highlights a common billing dynamic where cash payments can be more cost-effective than insurance claims, particularly for patients with high deductibles who may otherwise face the full negotiated amount. While the facility's cash rate is competitive, it is important to note that the median negotiated rate of $116.00 remains significantly higher than the Medicare benchmark of $10.56, illustrating how commercial contracts often exceed the federal cost baseline.
To ensure you receive the most accurate and lowest possible price, we recommend requesting an itemized bill before finalizing payment, as summary invoices can obscure individual line items and potential errors. Additionally, since this facility is a Critical Access Hospital, you should explicitly ask about "prompt-pay" discounts or self-pay rates prior to scheduling your visit, as these upfront incentives can further reduce the total cost. While the facility is located in a rural area with a specific zip code of 66097, the data provided does not include specific county or state average comparisons for this procedure, so the most reliable benchmark for evaluating fair pricing remains the Medicare rate of $10.56.