Blood test, comprehensive metabolic panel
Facility: Cloud County Health Center
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $195
- Cash Discount Price: $144
- vs. Medicare Baseline: 18.47x 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 1847% of the Medicare baseline (a markup of 1747%). 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 | $185 - $191 | 1752% |
| Mpi-All Plans | $195 | 1847% |
| Health Partners - All Plans | $195 | 1847% |
| Pponext-All Plans | $195 | 1847% |
Consumer Guidance & Cost Commentary
For this comprehensive metabolic panel at Cloud County Health Center in Concordia, KS, the facility's cash price of $144.00 is lower than the median negotiated rate of $195.00 paid by four major payers, including Aetna and MPI-All Plans. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that cash payments can sometimes be more cost-effective than using insurance, particularly if your plan has a high deductible or if the insurance negotiated rate exceeds the cash price. To maximize savings, it is advisable to ask the billing department directly about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
When reviewing your bill, ensure you are comparing rates against the Medicare benchmark rather than the hospital's inflated chargemaster list. The Medicare allowed amount for this service is $10.56, which serves as a scientifically validated baseline for the true cost of care; commercial rates are often significantly higher due to administrative overhead and contract dynamics. If you receive a bill that appears to include unexpected charges, request a full itemized audit to verify that all services rendered are accurately coded and that no balance billing has occurred, especially if you are an out-of-network patient or if ancillary services were provided outside the network.