Blood test, comprehensive metabolic panel
Facility: Osborne County Memorial Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $148
- Cash Discount Price: $139
- vs. Medicare Baseline: 14.02x 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 1402% of the Medicare baseline (a markup of 1302%). 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 |
|---|---|---|
| UnitedHealthcare | $124 | 1174% |
| Health Partners Of Kansas | $140 | 1326% |
| Wppa | $155 | 1468% |
| Blue Cross Blue Shield | $160 | 1515% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel (CPT 80053) at Osborne County Memorial Hospital in Osborne, KS, the facility's cash price of $139.00 is notably lower than the negotiated rates charged to commercial payers, which range from $124 to $160 depending on the insurance plan. This cash rate also sits below the state average for this service, offering a potential savings opportunity for patients with high-deductible plans who may not yet have met their out-of-pocket limits. While the facility is a Critical Access Hospital with government-local ownership, patients should verify their specific plan's negotiated amount before scheduling, as some commercial contracts may exceed the cash price, making upfront payment the most economical option.
The facility's negotiated rates are approximately 14% higher than the Medicare benchmark of $10.56, reflecting the typical administrative markup and contract dynamics inherent in commercial insurance billing. Because the No Surprises Act prohibits balance billing for out-of-network services at in-network facilities, patients can generally expect to pay only the negotiated amount rather than the full chargemaster gross of $163.00. To maximize savings, it is advisable to request a prompt-pay discount or self-pay rate directly from the billing department prior to check-in, as these upfront payment incentives can further reduce the final cost compared to standard insurance processing.