Blood test, comprehensive metabolic panel
Facility: Clara Barton Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $140
- Cash Discount Price: $109
- vs. Medicare Baseline: 13.26x 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 1326% of the Medicare baseline (a markup of 1226%). 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% |
| 6 Degrees Health - All Plans | $108 | 1023% |
| Wppa-All Plans | $124 | 1174% |
| Phcs - All Plans | $140 | 1326% |
| Aetna | $140 | 1326% |
| UnitedHealthcare | $140 | 1326% |
| Hlth Partners Of Ks-All Plans | $143 | 1354% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel (CPT 80053) at Clara Barton Hospital in Hoisington, KS, the cash price is $109.00, which is lower than the facility's negotiated rate of $140.00. While the facility's negotiated rate aligns with the state average of $140.00, the cash price remains the most affordable option for patients without insurance. If you have a high-deductible plan, paying the cash price of $109.00 upfront may be cheaper than your insurance applying its negotiated rate of $140.00, especially if you have not yet met your deductible. To maximize savings, we recommend asking the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
This service is benchmarked against the Medicare rate of $10.56, showing a markup of 13.3% above the federal baseline. It is important to note that commercial negotiated rates often exceed Medicare benchmarks due to administrative costs and contract structures, but the cash price here reflects a more direct cost. If you receive an itemized bill later, ensure it breaks down the specific CPT code to avoid confusion with bundled charges or services not rendered. Always request a full itemized statement before paying to verify that no errors, such as unbundled codes or charges for cancelled tests, have been included in your total.