Blood test, comprehensive metabolic panel
Facility: Stafford County Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $188
- Cash Discount Price: $198
- vs. Medicare Baseline: 17.80x 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 1780% of the Medicare baseline (a markup of 1680%). 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 |
|---|---|---|
| Va Ccn-All Plans | $21 | 199% |
| UnitedHealthcare | $21 | 199% |
| Health Partners-All Plans | $188 | 1780% |
| Medica Mcr- All Plans | $198 | 1875% |
| Humana | $198 | 1875% |
Consumer Guidance & Cost Commentary
For this comprehensive metabolic panel at Stafford County Hospital in Stafford, KS, the cash price of $198.00 is significantly lower than the facility's negotiated rates with major payers like Health Partners ($188) and Medica ($198). While the facility is a Critical Access Hospital with government ownership, patients should note that commercial insurance contracts often include administrative overheads that inflate the final bill. If you have a high-deductible plan, paying the cash price of $198.00 upfront might be more cost-effective than relying on insurance, especially since the median negotiated rate of $188.00 suggests that insurance processing could add hidden costs or result in higher out-of-pocket expenses once deductibles are met.
To ensure you are getting the best possible rate, it is crucial to verify your specific plan's allowed amount before scheduling, as in-network rates vary widely even within the same facility. The Medicare benchmark for this service is $10.56, which serves as a scientifically validated baseline for the true cost of care; commercial rates are typically marked up significantly above this figure. Additionally, you should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if you settle the bill immediately. Finally, always request a full itemized bill before paying to avoid errors or double-charging, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit.