Blood test, comprehensive metabolic panel
Facility: Mitchell County Hospital Health Systems
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $199
- Cash Discount Price: $188
- vs. Medicare Baseline: 18.84x 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 1884% of the Medicare baseline (a markup of 1784%). 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 | $11 - $209 | 104% |
| Blue Cross Blue Shield | $23 | 218% |
| Triwest Well Mark All Plans | $178 | 1686% |
| First Health-All Plans | $188 | 1780% |
| Pref Hlth Care Sytms Comm - All Plans | $188 | 1780% |
| Aetna | $188 | 1780% |
| Multiplan Ppo - All Plans | $199 | 1884% |
| Auxiant-All Plans | $199 | 1884% |
| Phc Leased Ntwrk Access - All Plans | $199 | 1884% |
| Cigna | $207 | 1960% |
| Health Partners Ks-All Plans | $207 | 1960% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel (CPT 80053) at Mitchell County Hospital Health Systems in Beloit, KS, the facility's cash price of $188.00 is notably lower than the median negotiated rates of $199.00 and the gross charge of $209.00. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rates paid by insurers like UnitedHealthcare and Cigna exceed the cash amount. It is important to note that while the facility offers a cash rate, commercial insurance contracts often include administrative overhead that inflates the baseline price, meaning the "savings" off the gross charge are less significant than the difference between the cash price and the Medicare benchmark of $10.56.
When reviewing your specific bill, be aware that summary invoices may obscure individual line items, potentially hiding errors such as unbundled codes or services not rendered. Since over 80% of hospital bills contain errors, requesting a full itemized audit before payment is the most effective way to reduce medical debt. Additionally, if you encounter a balance bill for out-of-network ancillary services, remember that the No Surprises Act generally prohibits providers from charging you the difference between their full rate and your insurance allowed amount for emergency care or non-emergency services at in-network facilities. To ensure you receive the best possible rate, contact the hospital directly to confirm their self-pay or prompt-pay discounts, which can range from 20% to 50% off the billed amount if paid in full upfront, bypassing the costly claims