Blood test, comprehensive metabolic panel
Facility: Morris County Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $92
- Cash Discount Price: $141
- vs. Medicare Baseline: 8.71x 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 871% of the Medicare baseline (a markup of 771%). 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 |
|---|---|---|
| Providrs Care (Wppa)(Nexus)-All Plans | $11 | 104% |
| Aetna | $13 | 123% |
| Blue Cross Blue Shield | $22 - $92 | 208% |
| Va Ccn-All Plans | $25 | 237% |
| Coventry Mcr | $92 | 871% |
| Choice Care Mcr Adv-All Plans | $92 | 871% |
| UnitedHealthcare | $92 - $235 | 871% |
| Cigna | $170 | 1610% |
| Multiplan-All Plans | $212 | 2008% |
| Coventry Comm-All Other Plans | $212 | 2008% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel (CPT 80053) at Morris County Hospital in Council Grove, Kansas, the cash price is $141.00, which is lower than the state average of $235.00. While the facility's negotiated rates with insurance carriers range from $11 to $235, the cash price often represents a more affordable option for patients with high-deductible plans or those without coverage. Because commercial negotiated rates can sometimes exceed the cash price due to administrative overhead and contract structures, patients are encouraged to verify their specific plan's allowed amount before scheduling. Additionally, patients should inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can further reduce the final cost if the bill is settled in full upfront.
It is important to understand that the $10.56 Medicare benchmark serves as the true cost baseline for this service, revealing that the gross chargemaster price of $235.00 includes significant markups. Commercial rates are often inflated by administrative costs and lack of competition, whereas the cash price reflects a direct transaction without insurance processing fees. If you receive a bill from an out-of-network provider or encounter unexpected charges, you may be subject to balance billing, which is largely prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act. To avoid errors, always request a detailed, itemized bill rather than a summary invoice, as over 80% of hospital bills contain mistakes such as unbundled codes or charges for services not rendered. Disputing these errors in writing with the billing supervisor is the most effective way to ensure you are only paying for what