Blood test, comprehensive metabolic panel
Facility: Lindsborg Community Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $188
- Cash Discount Price: $144
- vs. Medicare Baseline: 17.80x 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 1780% of the Medicare baseline (a markup of 1680%). 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 | 208% |
| Tricare | $96 | 909% |
| Coventry Mcr Adv | $97 | 919% |
| Cigna | $175 | 1657% |
| UnitedHealthcare | $185 | 1752% |
| Coventry Comm-All Other Plans | $185 | 1752% |
| Phcs Preferred-All Plans | $191 | 1809% |
| Multiplan-All Plans | $191 | 1809% |
| Wppa-All Plans | $195 | 1847% |
| Coventry Wc | $195 | 1847% |
| Century Health-All Plans | $195 | 1847% |
| Health Partners -All Plans | $195 | 1847% |
Consumer Guidance & Cost Commentary
For this comprehensive metabolic panel at Lindsborg Community Hospital, the cash price of $144.00 is lower than the median negotiated rate of $191.00 paid by insurance plans. While the facility is a Critical Access Hospital in Kansas, the data provided does not include specific county or state average comparisons for this service, so no direct regional benchmarking is available. Patients with high-deductible plans may find the cash price advantageous if their insurance negotiated rate exceeds this amount, as paying out-of-pocket upfront can sometimes result in lower total costs. It is important to note that while the facility offers a cash rate, commercial payers like Blue Cross Blue Shield and Tricare have negotiated rates ranging from $22.00 to $195.00, meaning the cash price is not the lowest possible option for those with active coverage.
The Medicare benchmark for this procedure is $10.56, which serves as a baseline for evaluating the facility's pricing markup. The cash price of $144.00 represents a significant increase over the Medicare rate, reflecting the complexity of the test and local cost structures. If you are billed for this service, you should request an itemized billing audit to ensure no errors, such as unbundled codes or services not rendered, are included in the final charge. Additionally, patients should inquire about prompt-pay discounts before scheduling, as paying in full upfront can often reduce the total amount owed compared to the standard cash price. Always verify your specific plan's deductible status and allowed amounts with the hospital prior to receiving care to avoid unexpected balances.