Blood test, comprehensive metabolic panel
Facility: Greeley County Health Services
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $11
- Cash Discount Price: $39
- vs. Medicare Baseline: 1.04x 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.
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 | $11 | 104% |
| Medicaid / KanCare | $11 | 104% |
Consumer Guidance & Cost Commentary
For this comprehensive metabolic panel at Greeley County Health Services in Tribune, Kansas, the cash price of $39.00 is significantly lower than the facility's negotiated rates of $11.00 for both Aetna and Medicaid/KanCare. While the cash price appears higher than the negotiated amount listed here, it is important to note that cash-pay options can sometimes be cheaper for patients with high-deductible plans if their insurance negotiated rate exceeds the cash price. Since the data shows a median negotiated rate of $11.00, patients should verify their specific plan's allowed amount before scheduling, as some commercial rates can be substantially higher than the facility's published negotiated figures. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before check-in, as these upfront payment incentives can further reduce the final cost.
The facility's pricing is benchmarked against Medicare, which sets a baseline rate of $10.56 for this procedure. The cash price of $39.00 represents a markup relative to this federal standard, illustrating how commercial rates often differ from the government's cost-based calculations. Because over 80% of hospital bills contain errors, patients should request a full itemized CPT-coded bill rather than accepting a summary invoice, which may obscure individual charges or unbundled services. If a balance bill arises from an out-of-network ancillary service, patients should not pay immediately out of fear of credit damage; instead, they should dispute the bill with their insurer and request a No Surprises Act audit to ensure they are not being charged for services not rendered or for out-of-network providers at an in-network facility.