CMS Price Transparency Data
Blood test, comprehensive metabolic panel
Facility: Mercy Hospital Joplin
Billing Code: 80053 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80053
- Insurance Median: $17
- Cash Discount Price: $23
- vs. Medicare Baseline: 1.61x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Mercy Hospital Joplin is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.61x the Medicare baseline. Located in 100 Mercy Way, Joplin, MO.
Cash / Self-Pay
$23
Average discount available for prompt cash payment at this facility.
Insurance Median
$17
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: $23 (218%)
Insurance Median: $17 (161%)
Cash: $23 (218% of Medicare)
Ins. Median: $17 (161% 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.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 |
|---|---|---|
| Aetna | $9 - $13 | 85% |
| Blue Cross Blue Shield | $9 - $26 | 85% |
| Humana | $9 - $11 | 85% |
| Medicaid / KanCare | $9 - $17 | 85% |
| Champva [20065] | $10 | 95% |
| Cherokee Nation Health Serv Contracted [320066] | $10 | 95% |
| Cigna | $10 - $60 | 95% |
| Cross Timbers Hospice [20098] | $10 | 95% |
| Dept Of Veteran Affairs Contracted [320106] | $10 | 95% |
| Elara Caring Aspire Hospice [20433] | $10 | 95% |
| Globalhealth Contracted [320145] | $10 | 95% |
| Halo Hcr Inc Hospice Contracted [320432] | $10 | 95% |
| Halo Hcr Inc Hospice [20432] | $10 | 95% |
| Indian Health Service Contracted [320198] | $10 - $23 | 95% |
| Kindful Hospice Contracted [320434] | $10 | 95% |
| Kindful Hospice [20434] | $10 | 95% |
| Medica Contracted [320239] | $10 | 95% |
| Medicare (plans) | $10 - $11 | 95% |
| Mercy Hospice Okc [20252] | $10 | 95% |
| Mercy Mgd Behavioral Health Contracted [320259] | $10 | 95% |
| Pace Of The Ozarks Contracted [320518] | $10 | 95% |
| Provider Partners Health Plans Contracted [320450] | $10 | 95% |
| Qual Choice Contracted [320325] | $10 | 95% |
| Tricare | $10 | 95% |
| UnitedHealthcare | $10 - $14 | 95% |
| United Medical Resources Contracted [320454] | $11 - $37 | 104% |
| Health Choice Contracted [320166] | $13 | 123% |
| Healthscope Contracted [320182] | $13 | 123% |
| Point C Contracted [320238] | $13 - $29 | 123% |
| Benefit Management Contracted [320052] | $15 | 142% |
| Health Systems Inc Contracted [320174] | $15 | 142% |
| Insurance System Inc Contracted [320465] | $15 | 142% |
| Administrative Payor Contracted [320005] | $16 | 152% |
| Ambetter / Centene | $17 | 161% |
| Centivo Contracted [320505] | $17 | 161% |
| Home State Health Plan Contracted [320187] | $17 | 161% |
| Novasys Contracted [320285] | $17 | 161% |
| Mercy Benefit Admin Contracted [320251] | $18 - $65 | 170% |
| Providrs Care Network Contracted [320484] | $20 | 189% |
| Aither Health Contracted [320449] | $21 | 199% |
| Auxiant Contracted [320462] | $21 - $23 | 199% |
| Ebms Contracted [320493] | $21 | 199% |
| Edison Health Solutions Contracted [320502] | $21 | 199% |
| Healthlink Contracted [320179] | $21 - $63 | 199% |
| Imagine 360 Contracted [320494] | $21 | 199% |
| Reflect Health Contracted [320492] | $21 | 199% |
| Yuzu Health Contracted [320521] | $21 | 199% |
| Preferred Health Plan Contracted [320522] | $23 | 218% |
| American Healthcare Alliance Contracted [320020] | $25 | 237% |
| First Health Contracted [320128] | $25 | 237% |
| Multiplan Contracted [320270] | $28 | 265% |
| Private Health Care Systems Contracted [320320] | $28 | 265% |
| Usable Contracted [320409] | $28 | 265% |
| Point C [20238] | $29 | 275% |
| Workers Comp [20426] | $29 - $36 | 275% |
| Ppo Plus Contracted [320310] | $32 | 303% |
| Usa Managed Care Org Contracted [320429] | $32 | 303% |
| 90 Degree Benefits Contracted [320436] | $62 | 587% |
| Show-Me Health Administrators Contracted [320483] | $62 - $65 | 587% |