Blood test, comprehensive metabolic panel
Facility: Children'S Mercy South
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $81
- Cash Discount Price: $60
- vs. Medicare Baseline: 7.67x 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 767% of the Medicare baseline (a markup of 667%). 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 | $10 - $83 | 95% |
| Medicaid / KanCare | $12 | 114% |
| Healthy Blue | $12 - $29 | 114% |
| Home State Health | $25 | 237% |
| Blue Cross Blue Shield | $51 - $92 | 483% |
| Cigna | $60 - $86 | 568% |
| Medica | $72 | 682% |
| Aetna | $74 - $84 | 701% |
| Orscheln | $81 | 767% |
| Wellfit/Centrus | $81 | 767% |
| Quiktrip | $81 | 767% |
| Nebraska Furniture Mart | $81 | 767% |
| Centivo | $81 | 767% |
| Wppa Providrs Care | $81 | 767% |
| Health Midwest Comprehensive Care | $81 | 767% |
| Humana | $82 | 777% |
| Coventry Health Care Of Kansas | $92 | 871% |
| Coxhealth Network | $92 | 871% |
| Mercy Health | $93 | 881% |
| Multiplan | $94 | 890% |
| American Healthcare Alliance | $105 | 994% |
| Healthlink | $109 | 1032% |
| National Preferred Provider Network | $112 | 1061% |
Consumer Guidance & Cost Commentary
For the comprehensive metabolic panel (CPT 80053) at Children's Mercy South in Overland Park, KS, the cash price of $60.00 is significantly lower than the facility's average negotiated rates, which range from $10 to $112 across 23 payers. While the cash price is notably lower than the state average, patients with high-deductible plans may find the cash rate more beneficial if their insurance negotiated rates exceed $60.00, as paying out-of-pocket could result in immediate savings. However, it is important to note that commercial insurance contracts often include administrative overheads that can inflate the baseline price by 20% to 40%, meaning the negotiated rate does not always reflect the true cost of care.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency services at in-network facilities, unexpected ancillary charges or out-of-network lab services could still trigger surprise bills if not carefully reviewed. To avoid these issues, consumers should request a full itemized CPT-coded bill before finalizing payment, as summary bills often obscure individual line items and unbundled charges. Additionally, asking the facility about "self-pay" or "prompt-pay" discounts prior to scheduling can help secure a fee reduction, potentially lowering the final cost further below the standard cash price of $60.00.