Blood test, comprehensive metabolic panel
Facility: Kiowa District Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $151
- Cash Discount Price: $128
- vs. Medicare Baseline: 14.30x 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 1430% of the Medicare baseline (a markup of 1330%). 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 | $22 | 208% |
| Healthchoice-All Plans | $48 | 455% |
| Tricare | $62 | 587% |
| UnitedHealthcare | $128 - $160 | 1212% |
| Health Partners Of Ks-All Plans | $141 | 1335% |
| Humana | $144 | 1364% |
| Gbs Insurance - All Plans | $150 | 1420% |
| Multiplan-All Plans | $150 | 1420% |
| Medicare (plans) | $152 | 1439% |
| Aetna | $152 | 1439% |
| Triwest-All Plans | $152 | 1439% |
| Medicaid / KanCare | $160 | 1515% |
| Providers Care (Wppa)-All Plans | $240 | 2273% |
| Liberty Healthshare-All Plans | $258 | 2443% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel (CPT 80053) at Kiowa District Hospital in Kiowa, KS, the cash price is $128.00, which is lower than the facility's negotiated rates with most insurance plans. While the hospital's negotiated rates range from $22.00 for Blue Cross Blue Shield up to $258.00 for Liberty Healthshare, the cash price of $128.00 represents a significant discount compared to the median negotiated rate of $151.00. For patients with high-deductible plans or those without insurance, paying the cash price directly can be more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. Additionally, patients should inquire about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill.
This service is provided by a Critical Access Hospital, and the facility's pricing structure is benchmarked against federal standards. The Medicare reimbursement rate for this procedure is $10.56, which serves as the baseline for evaluating commercial pricing. Although the data does not include specific state or county average comparisons for this code, the facility's cash price of $128.00 is notably higher than the Medicare rate, reflecting the complexity of commercial billing. To ensure you are receiving the most accurate and transparent pricing, it is recommended to request an itemized bill that details every charge, avoiding summary invoices that may obscure individual costs. Always verify your specific plan's deductible status and allowed amounts before proceeding to avoid unexpected out-of-pocket expenses.