Blood test, comprehensive metabolic panel
Facility: Amberwell Atchison Association
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $54
- Cash Discount Price: $105
- vs. Medicare Baseline: 5.11x 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 511% of the Medicare baseline (a markup of 411%). 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% |
| UnitedHealthcare | $35 - $188 | 331% |
| Humana | $35 - $47 | 331% |
| Va Ccn - All Plans | $35 | 331% |
| Triwest - All Plans | $35 | 331% |
| Superior Select Mcr Adv - All Plans | $35 | 331% |
| Ambetter / Centene | $54 | 511% |
| Cigna | $58 | 549% |
| Aetna | $58 | 549% |
| Centrus Health Direct - All Plans | $79 | 748% |
| Oscar - All Plans | $79 | 748% |
| Multiplan - All Plans | $82 | 777% |
| Wppa Providrs Care - All Plans | $94 | 890% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel (CPT 80053) at Amberwell Atchison Association in Atchison, KS, the cash price is $105.00, which matches the facility's cash median. This rate is significantly higher than the Medicare benchmark of $10.56, illustrating how commercial rates often exceed the federal cost baseline used for pricing transparency. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that their insurance negotiated rates vary widely; for instance, Blue Cross Blue Shield plans pay as low as $22.00, whereas Cigna and Aetna pay $58.00. Because these negotiated amounts can sometimes be lower than the cash price, patients with high-deductible plans might find it financially advantageous to pay the cash rate directly, provided they confirm the facility offers a "self-pay" or "prompt-pay" discount that further reduces the $105.00 charge.
The median amount paid by insurers for this service is $52.00, which is roughly half the cash price, yet this does not guarantee the lowest possible out-of-pocket cost for every patient. It is important to verify your specific plan's deductible status before scheduling, as you may be responsible for the full negotiated rate if you have not yet met your annual threshold. Additionally, while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to request an itemized bill to ensure no unbundled codes or services not rendered are included. Given that over 80% of hospital bills contain errors, patients should always review their statement line-by-line rather