CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Rockcastle County Hospital, Inc.

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $82
Cash Discount Price: $131
vs. Medicare Baseline: 7.77x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Rockcastle County Hospital, Inc. is $82. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $131. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 7.77x the Medicare baseline. Located in 145 Newcomb Avenue, Mount Vernon, KY.

Cash / Self-Pay

$131

Average discount available for prompt cash payment at this facility.

Insurance Median

$82

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$10.56

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $10.56 (100%)

Cash / Self-Pay: $131 (1241%)

Insurance Median: $82 (777%)

Cash: $131 (1241% of Medicare)

Ins. Median: $82 (777% of 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 777% of the Medicare baseline (a markup of 677%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

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	$7 - $119	66%
Tricare	$8	76%
Caresource Mcr Adv-All Other Plans	$11	104%
Humana	$11	104%
Molina Marketplace - All Other Plans	$11	104%
Molina Mcr Adv	$11	104%
Signature Mcr Adv-All Plans	$11	104%
Wellcare Mcr Adv-All Other Plans	$11	104%
Passport Hp Hmo - All Plans	$47	445%
Multiplan-All Plans	$147	1392%
Prime Health Services-All Plans	$147	1392%
Integrated Hp-All Plans	$154	1458%
Corvel - All Plans	$156	1477%
Center Care-All Plans	$164	1553%
Cigna	$168	1591%
Caresource Mcaid	$173	1638%
Coventry Mcaid-All Plans	$173	1638%
Medicaid / KanCare	$173	1638%
Molina Mcaid	$173	1638%
UnitedHealthcare	$173	1638%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $131.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80053.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Rockcastle County Hospital, Inc. is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 80053.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.