Blood test, comprehensive metabolic panel
Facility: Kiowa County Memorial Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $125
- Cash Discount Price: $119
- vs. Medicare Baseline: 11.84x 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 1184% of the Medicare baseline (a markup of 1084%). 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 - $125 | 218% |
| UnitedHealthcare | $112 - $140 | 1061% |
| Health Partners Of Ks-All Plans | $123 | 1165% |
| Humana | $125 | 1184% |
| Celtic Comml Exchange-All Other Plans | $125 | 1184% |
| Medica Prime Mcare Cost-All Plans | $125 | 1184% |
| Aetna | $125 | 1184% |
| Medicaid / KanCare | $140 | 1326% |
| Providrs Care/Wppa-All Plans | $210 | 1989% |
Consumer Guidance & Cost Commentary
For this comprehensive metabolic panel at Kiowa County Memorial Hospital in Greensburg, KS, the negotiated rates range from $23 to $210 depending on your specific insurance plan, with a median negotiated amount of $125. While the facility's cash price of $119 is slightly lower than the median negotiated rate, it is important to note that commercial insurance contracts often include administrative overhead that can inflate the final allowed amount. If you have a high-deductible plan, paying the cash price of $119 upfront may result in lower out-of-pocket costs compared to your insurance paying its negotiated rate of $125 and you covering the remainder of your deductible. Additionally, patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts, which can further reduce the final bill if settled in full before the due date.
The facility's pricing is benchmarked against federal standards, showing a Medicare amount of $10.56. While the data provided does not include specific Kansas or Kiowa County average rates for this procedure, the facility is a Critical Access Hospital owned by the local government, which often influences its pricing structure. Under federal protections like the No Surprises Act, patients should be aware that balance billing for out-of-network services at in-network facilities is generally prohibited, though unexpected charges can still occur for ancillary services. To ensure accuracy, we recommend requesting a detailed, itemized bill that breaks down every CPT code and charge, as summary bills often obscure errors or unbundled fees that could be disputed to reduce your total medical debt.