Blood test, comprehensive metabolic panel
Facility: Kingman Healthcare Center
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $3
- Cash Discount Price: $4
- vs. Medicare Baseline: 0.28x 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.
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 |
|---|---|---|
| Ambetter / Centene | $3 | 28% |
| Celtic Insurance Company | $3 | 28% |
| Humana | $3 | 28% |
| Medicaid / KanCare | $3 - $11 | 28% |
| UnitedHealthcare | $3 - $6 | 28% |
| Wellcare | $3 | 28% |
| Aetna | $6 | 57% |
| Cigna | $6 | 57% |
| Health Partners | $6 | 57% |
| Healthy Blue | $11 | 104% |
| Triwest | $11 | 104% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel (CPT 80053) at Kingman Healthcare Center in Kingman, KS, the cash median price is $4.00, which is significantly lower than the facility's gross charge of $7.00. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should note that commercial negotiated rates often exceed cash prices due to administrative overhead and contract dynamics. For instance, the median negotiated rate across payers is $3.00, yet the cash price remains the lowest available option at $4.00. This suggests that for patients with high-deductible plans or those without insurance, paying cash directly may result in lower out-of-pocket costs compared to using an in-network plan where the insurer's allowed amount could be higher.
When comparing pricing to federal benchmarks, the Medicare amount for this service is $10.56, which serves as a reliable baseline for evaluating fair pricing. The facility's cash rate of $4.00 is roughly 38% of the Medicare amount, indicating a substantial discount relative to the government's cost-based reimbursement. However, it is important to distinguish between the facility's gross charges and its negotiated rates; patients should avoid using the gross charge as a benchmark for savings. To ensure the lowest possible cost, patients are encouraged to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill by 20% to 50% when paid upfront. Additionally, if a patient receives care from an out-of-network provider at this facility, they may be protected from balance billing by the No Surprises Act for non-emergency services