Blood test, comprehensive metabolic panel
Facility: Hodgeman County Health Center
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $134
- Cash Discount Price: $152
- vs. Medicare Baseline: 12.69x 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 1269% of the Medicare baseline (a markup of 1169%). 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 | $22 - $23 | 208% |
| Humana | $122 | 1155% |
| Medicaid / KanCare | $122 - $190 | 1155% |
| UnitedHealthcare | $122 - $180 | 1155% |
| Triwest - All Plans | $122 | 1155% |
| Aetna | $152 | 1439% |
| First Health - All Plans | $171 | 1619% |
| Wppa (Provdrscare) - All Plans | $180 | 1705% |
| Health Partners - All Plans | $180 | 1705% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel (CPT 80053) at Hodgeman County Health Center in Jetmore, Kansas, the cash price is $152.00, which is notably higher than the state average of $143.00. While commercial insurance plans like Blue Cross Blue Shield and Humana negotiate rates ranging from $22 to $190, these negotiated amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. It is important to note that Medicaid/KanCare plans show a range of $122 to $190, and UnitedHealthcare ranges from $122 to $180, so verifying your specific plan's allowed amount is essential before scheduling.
This facility, a Critical Access Hospital with government-local ownership, lists a Medicare benchmark of $10.56, which serves as the objective baseline for evaluating pricing markups. The facility's cash rate of $152.00 represents a significant markup over the Medicare amount, illustrating how commercial rates can differ substantially from the federal cost basis. To ensure you are receiving fair pricing, we recommend requesting an itemized bill to review specific CPT codes and avoid summary bills that may obscure individual charges, and asking about prompt-pay discounts before check-in to potentially reduce the final amount owed.