Blood test, comprehensive metabolic panel
Facility: Community Memorial Healthcare, Inc.
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $43
- Cash Discount Price: $83
- vs. Medicare Baseline: 4.07x 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 407% of the Medicare baseline (a markup of 307%). 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% |
| Aetna | $34 - $68 | 322% |
| UnitedHealthcare | $43 - $51 | 407% |
Consumer Guidance & Cost Commentary
For this comprehensive metabolic panel at Community Memorial Healthcare in Marysville, Kansas, the cash price of $83.00 is significantly lower than the facility's negotiated rates with major insurers like Aetna ($34.00 to $68.00) and UnitedHealthcare ($43.00 to $51.00). While the facility's cash rate matches the national median paid amount of $68.00 exactly, patients with high-deductible plans may find paying out-of-pocket cheaper than relying on insurance, which often results in higher allowed amounts due to administrative overhead and contract dynamics. It is important to note that the facility's negotiated rates are substantially higher than the Medicare benchmark of $10.56, illustrating how commercial contracts can inflate costs compared to the federal government's cost-based baseline.
Before scheduling, patients should verify their specific plan details and ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final balance by 20% to 50%. If you choose to use insurance, be aware that balance billing could occur if an out-of-network provider bills the full chargemaster rate for services not covered by the No Surprises Act, though federal protections exist for emergency care at in-network facilities. To ensure you are not overcharged, always request a full itemized bill before paying, as summary invoices often hide unbundled codes or services not rendered. Comparing this facility's pricing to state and county averages is not possible with the current data, but understanding the difference between the cash price, your insurance allowed amount, and the Medicare rate is essential for making informed financial decisions.