Blood test, comprehensive metabolic panel
Facility: Republic County Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $117
- Cash Discount Price: $95
- vs. Medicare Baseline: 11.08x 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 1108% of the Medicare baseline (a markup of 1008%). 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 |
|---|---|---|
| Rural Carriers-All Plans | $108 | 1023% |
| Aetna | $114 | 1080% |
| Meritain-All Plans | $114 | 1080% |
| UnitedHealthcare | $117 | 1108% |
| First Health-All Plans | $121 | 1146% |
| Cigna | $121 | 1146% |
| Midlands Choice-All Plans | $121 | 1146% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel (CPT 80053) at Republic County Hospital in Belleville, KS, the facility's cash price of $95.00 is lower than the state average of $117.00 and the county average of $108.00. While the facility's cash rate is also below the national average of $108.00, patients with high-deductible plans may find paying cash directly more cost-effective than using insurance, as the negotiated rates for in-network payers range from $108.00 to $121.00. It is important to note that even though the facility is a Critical Access Hospital and a voluntary non-profit, the cash price remains the most transparent baseline for comparison. Patients should verify their specific plan's deductible status before scheduling, as paying the cash price upfront can sometimes result in immediate savings compared to the administrative costs and potential out-of-pocket maximums associated with insurance claims.
If you choose to use insurance, you should be aware that the facility's negotiated rates are generally higher than the cash price due to the administrative overhead and contract structures required for billing. The median negotiated rate across payers is $117.00, which exceeds the cash price of $95.00. To maximize savings, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before check-in, as these programs often offer significant reductions for upfront payments. Additionally, if you receive a bill that includes charges for services not rendered or unbundled components, you have the right to request a formal itemized billing audit to identify errors before paying. Always ensure you are comparing rates