Blood test, comprehensive metabolic panel
Facility: Minneola District Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $32
- Cash Discount Price: $25
- vs. Medicare Baseline: 3.03x 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 303% of the Medicare baseline (a markup of 203%). 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% |
| Humana | $24 | 227% |
| Va Community Care Program-All Plans | $24 | 227% |
| UnitedHealthcare | $24 - $36 | 227% |
| Corporate Plan Management-All Plans | $31 | 294% |
| Providrs Care Network-All Plans | $31 | 294% |
| Triwest-All Plans | $32 | 303% |
| Preferred Health Care (Coventry)-All Other Plans | $32 | 303% |
| Health Partners Of Kansas-All Plans | $34 | 322% |
| Aetna | $34 - $36 | 322% |
| Phc (Coventry) Leased Network | $34 | 322% |
| Medicaid / KanCare | $36 | 341% |
Consumer Guidance & Cost Commentary
For this comprehensive metabolic panel at Minneola District Hospital, the cash price of $25.00 is lower than the facility's negotiated rates, which range from $23.00 to $36.00 depending on the insurance plan. While the cash price is competitive, it is important to note that for patients with high-deductible plans, paying the cash price upfront can sometimes be cheaper than the insurance negotiated rate if the allowed amount exceeds the cash price. To ensure you receive the best possible rate, we recommend contacting the hospital directly to inquire about self-pay discounts or prompt-pay incentives before scheduling your visit.
The facility's negotiated rates are significantly higher than the Medicare benchmark of $10.56, reflecting the administrative costs and contract structures inherent in commercial insurance. Under the No Surprises Act, patients are protected from balance billing for out-of-network services at in-network facilities, but it is still advisable to request an itemized bill to verify that all charges are accurate and that no unbundled codes or services not rendered have been included. If you receive a bill that seems unusually high, you have the right to dispute it in writing with the billing supervisor to ensure the final amount reflects the true cost of care.