Blood test, comprehensive metabolic panel
Facility: Wilson Medical Center
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $22
- Cash Discount Price: $31
- vs. Medicare Baseline: 2.08x 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 208% of the Medicare baseline (a markup of 108%). 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 |
|---|---|---|
| UnitedHealthcare | $6 - $66 | 57% |
| Ambetter / Centene | $6 - $71 | 57% |
| Tricare | $6 - $38 | 57% |
| Humana | $6 - $38 | 57% |
| Aetna | $6 - $71 | 57% |
| Cigna | $10 - $57 | 95% |
| Health Partners-All Plans | $11 - $65 | 104% |
| Mulitplan-All Plans | $11 - $65 | 104% |
| Blue Cross Blue Shield | $12 - $71 | 114% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel (CPT 80053) at Wilson Medical Center in Neodesha, KS, the facility's cash median price is $31.00, which is lower than the negotiated rates paid by most commercial insurers. While the facility's negotiated rates range from $6 to $71 across nine payers, the cash price offers a potential savings for patients with high-deductible plans or those without insurance, as the cash rate is significantly below the average commercial negotiated amount. It is important to note that commercial insurance contracts often include administrative overheads that inflate the baseline price by 20% to 40%, meaning the cash price may represent the most cost-effective option for self-pay patients.
The facility's cash rate of $31.00 is also notably lower than the Medicare benchmark of $10.56 when adjusted for the facility's specific cost structure, though the direct comparison shows the cash price is higher than the base Medicare amount of $10.56. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, it is still advisable to request a prompt-pay discount before scheduling, which can reduce the final bill by 20% to 50% for upfront payment. To ensure you are receiving the best possible rate, always verify the specific allowed amount with the hospital before your visit and request an itemized bill to confirm all charges are accurate and bundled correctly.