Blood test, comprehensive metabolic panel
Facility: Logan County Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $86
- Cash Discount Price: $25
- vs. Medicare Baseline: 8.14x 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 814% of the Medicare baseline (a markup of 714%). 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% |
| Humana | $53 | 502% |
| Health Partners - All Plans | $119 | 1127% |
| Medicaid / KanCare | $125 | 1184% |
Consumer Guidance & Cost Commentary
For this comprehensive metabolic panel at Logan County Hospital in Oakley, Kansas, the cash price is $25.00, which is significantly lower than the facility's negotiated rates of $86.00 and the Medicare benchmark of $10.56. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $25.00. It is important to note that while Medicaid/KanCare pays the full gross amount of $125.00, commercial payers like Blue Cross Blue Shield and Humana negotiate specific rates of $23.00 and $53.00 respectively, meaning the cash price remains the lowest option for self-pay patients.
To ensure you are not overcharged, we recommend requesting an itemized billing audit to verify that all charges are accurate and that no services were unbundled or rendered incorrectly, as over 80% of hospital bills contain errors. Additionally, before scheduling, ask the hospital to classify your account as "self-pay" to qualify for prompt-pay discounts, which can further reduce the cost by bypassing insurance claims processing fees. Since the facility is located in a rural area with a specific Medicare benchmark, comparing your final bill against the $10.56 Medicare rate provides a clearer picture of the true cost of care than comparing it to the inflated chargemaster list price.