Blood test, comprehensive metabolic panel
Facility: Norton County Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $32
- Cash Discount Price: $67
- vs. Medicare Baseline: 3.03x 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 303% of the Medicare baseline (a markup of 203%). 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 | $32 | 303% |
Consumer Guidance & Cost Commentary
For this comprehensive metabolic panel at Norton County Hospital, the cash price of $67.00 is notably lower than the negotiated rate of $32.00 listed for Blue Cross Blue Shield plans. While the facility is a Critical Access Hospital in Norton, Kansas, with government-local ownership, patients with high-deductible plans may find paying cash directly more economical than relying on insurance, as the cash price often falls below the insurer's negotiated ceiling. To maximize savings, we strongly recommend contacting the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can further reduce the final amount owed by bypassing administrative claim processing fees.
It is important to understand that commercial insurance rates are often inflated by administrative costs and contract structures, making the Medicare benchmark a more reliable indicator of true cost. In this case, the Medicare amount of $10.56 serves as the baseline for fair pricing, revealing that the cash rate of $67.00 represents a significant markup over federal standards. Because over 80% of hospital bills contain errors, patients should never accept a summary bill as final; instead, they should request a detailed, itemized statement to verify that all charges align with the specific CPT code for this blood test and to identify any unbundled services or items not rendered.