Blood test, comprehensive metabolic panel
Facility: Lincoln County Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $23
- Cash Discount Price: $218
- vs. Medicare Baseline: 2.18x 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 218% of the Medicare baseline (a markup of 118%). 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 | $23 | 218% |
Consumer Guidance & Cost Commentary
For this comprehensive metabolic panel at Lincoln County Hospital in Lincoln, KS, the cash price of $218.00 is significantly lower than the negotiated rate of $23.00 paid by Blue Cross Blue Shield, which is the only payer listed for this service. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans or those without insurance may find the cash price more affordable than their insurance coverage, as the negotiated rate often exceeds the cash price due to administrative costs and contract structures. It is important to note that the cash price of $218.00 is also lower than the gross chargemaster of $243.00, but comparing it directly to the Medicare amount of $10.56 reveals a substantial markup typical of commercial billing practices.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, it does not automatically eliminate all surprise costs if ancillary services are billed separately. To ensure you are not overcharged, request a full itemized bill before paying, as summary bills can obscure individual line items and potential errors. Additionally, ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final amount owed by 20% to 50% if paid in full upfront, bypassing the costly insurance claims process. Always verify your specific plan's deductible status and allowed amounts before scheduling, as paying the full negotiated rate without meeting your deductible can result in higher out-of-pocket expenses than paying the cash price directly.