Blood test, comprehensive metabolic panel
Facility: Memorial Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $113
- Cash Discount Price: $205
- vs. Medicare Baseline: 10.70x 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 1070% of the Medicare baseline (a markup of 970%). 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 | $16 | 152% |
| Humana | $103 | 975% |
| Tricare | $103 | 975% |
| Medicare (plans) | $104 | 985% |
| Ambetter / Centene | $113 | 1070% |
| Coventry - All Other Plans | $185 | 1752% |
| Preferred Healthcare-All Plans | $195 | 1847% |
| Health Partners Of Kansas - All Plans | $195 | 1847% |
| Wppa/Providers Care-All Plans | $287 | 2718% |
Consumer Guidance & Cost Commentary
For this comprehensive metabolic panel at Memorial Hospital in Abilene, KS, the cash price is $205.00, which matches the facility's median negotiated rate of $104.00 for most major payers like Humana and Medicare. While the hospital's negotiated rate of $113.00 is slightly higher than the lowest payer rate of $16.00, it remains significantly lower than the facility's gross charge of $205.00. Because the cash price ($205.00) is identical to the gross charge, patients with high-deductible plans or those without insurance may find paying out-of-pocket is the most cost-effective option, as insurance negotiated rates often include administrative overhead that inflates the final bill.
The facility's pricing is benchmarked against Medicare, which sets a fixed rate of $10.56 for this service. The hospital's cash price is approximately 1,070% of the Medicare rate, reflecting the high administrative costs and profit margins typical of commercial billing. However, the median negotiated rate of $113.00 is still well below the gross charge, demonstrating that in-network contracts provide substantial protection against balance billing. Patients should verify their specific plan details before scheduling, as some commercial payers may have different allowed amounts, and they should always ask about prompt-pay discounts or self-pay rates to ensure they are receiving the lowest possible price for this laboratory test.