Blood test, comprehensive metabolic panel
Facility: Stevens County Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $49
- Cash Discount Price: $100
- vs. Medicare Baseline: 4.64x 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 464% of the Medicare baseline (a markup of 364%). 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 |
|---|---|---|
| Aetna | $5 - $150 | 47% |
| Humana | $18 - $56 | 170% |
| Blue Cross Blue Shield | $22 - $23 | 208% |
| First Health - All Plans | $45 - $135 | 426% |
| Wppa - All Plans | $48 - $142 | 455% |
| Medicaid / KanCare | $50 - $150 | 473% |
Consumer Guidance & Cost Commentary
For the CPT code 80053 (Blood test, comprehensive metabolic panel) at Stevens County Hospital in Hugoton, KS, the cash price is $100.00, which matches the facility's cash median. This rate is significantly higher than the Medicare benchmark of $10.56, reflecting the typical markup found in commercial billing. While the facility is a Critical Access Hospital owned by the local government, patients should note that commercial negotiated rates for this service range from $5 to $150 across different payers, with Aetna plans showing the lowest range at $5 to $15. Because commercial negotiated rates often include administrative overhead and contract premiums, the cash price can sometimes be the most affordable option for individuals with high-deductible plans who have not yet met their out-of-pocket maximum.
To secure the best possible rate, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling their visit, as these upfront payment incentives can reduce the final bill by 20% to 50%. It is also important to verify your specific plan's allowed amount, as assuming that being in-network guarantees the lowest price is a common pitfall; some in-network contracts may result in higher charges than paying cash directly. Finally, if you receive a bill, request a full itemized statement to review every line item for errors or unbundled charges, as over 80% of hospital bills contain discrepancies that can be corrected through a formal written audit dispute.