Blood test, comprehensive metabolic panel
Facility: Stanton County Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $187
- Cash Discount Price: $67
- vs. Medicare Baseline: 17.71x 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 1771% of the Medicare baseline (a markup of 1671%). 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 - $230 | 208% |
| Healthy Blue Mcr Adv - All Other Plans | $185 - $238 | 1752% |
| Healthy Blue Mcaid | $189 - $207 | 1790% |
Consumer Guidance & Cost Commentary
For a comprehensive metabolic panel at Stanton County Hospital, the cash price of $67.00 is significantly lower than the negotiated rates commercial insurers typically pay, which range from $182.00 to $238.00 depending on the specific plan. This facility is a Critical Access Hospital in Johnson, Kansas, and its cash rate aligns exactly with the cash median reported for this service. While Medicare reimburses $10.56 for this procedure, the hospital's negotiated rates are approximately 17.7 times higher than the Medicare amount, reflecting the standard markup for commercial contracts. Patients with high-deductible plans may find it financially advantageous to pay the $67.00 cash price directly, as the insurance negotiated rates often exceed this amount, especially given that the facility is owned by the local government and may offer favorable self-pay terms.
To minimize costs, patients should verify if the hospital offers prompt-pay discounts, which can reduce the final bill by 20% to 50% if paid in full upfront, bypassing the administrative overhead associated with insurance claims. It is important to note that while the facility is in-network for three payers, the actual amount paid by the insurer ($182.00 median) is substantially higher than the cash price, illustrating that being in-network does not guarantee the lowest possible price. Before scheduling, patients should explicitly request a self-pay classification and a waiver of insurance submission to ensure they receive the cash rate rather than the higher negotiated amount. Additionally, since over 80% of hospital bills contain errors, patients should always request a detailed, itemized statement to audit the charges for any unbundled codes or services not rendered