CMS Price Transparency Data
Blood test, comprehensive metabolic panel
Facility: Mercy Hospital Springfield
Billing Code: 80053 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80053
- Insurance Median: $21
- Cash Discount Price: $266
- vs. Medicare Baseline: 1.99x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Mercy Hospital Springfield is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $266. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.99x the Medicare baseline. Located in 2115 S. Fremont Ave, Springfield, MO.
Cash / Self-Pay
$266
Average discount available for prompt cash payment at this facility.
Insurance Median
$21
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: $266 (2519%)
Insurance Median: $21 (199%)
Cash: $266 (2519% of Medicare)
Ins. Median: $21 (199% 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 |
|---|---|---|
| Blue Cross Blue Shield | $8 - $312 | 76% |
| Aetna | $9 - $13 | 85% |
| Humana | $9 - $278 | 85% |
| Medicaid / KanCare | $9 - $20 | 85% |
| Centurion Of Missouri [20459] | $10 | 95% |
| 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 | 95% |
| Indian Health Service [20198] | $10 | 95% |
| Kindful Hospice Contracted [320434] | $10 | 95% |
| Kindful Hospice [20434] | $10 | 95% |
| Medica Contracted [320239] | $10 | 95% |
| Medica [20239] | $10 | 95% |
| Medicare (plans) | $10 - $11 | 95% |
| Mercy Hospice Okc [20252] | $10 | 95% |
| Mercy Mgd Behavioral Health Contracted [320259] | $10 | 95% |
| Mercy Rehab Hospital Contracted [320260] | $10 | 95% |
| Pace Of The Ozarks Contracted [320518] | $10 | 95% |
| Qual Choice Contracted [320325] | $10 | 95% |
| Tricare | $10 | 95% |
| UnitedHealthcare | $10 - $315 | 95% |
| Provider Partners Health Plans Contracted [320450] | $11 | 104% |
| United Medical Resources Contracted [320454] | $11 - $213 | 104% |
| Healthscope Contracted [320182] | $13 | 123% |
| Centivo Contracted [320505] | $17 | 161% |
| Ambetter / Centene | $20 | 189% |
| Home State Health Plan Contracted [320187] | $20 | 189% |
| Novasys Contracted [320285] | $20 | 189% |
| Providrs Care Network Contracted [320484] | $20 | 189% |
| Aither Health Contracted [320449] | $21 - $233 | 199% |
| Auxiant Contracted [320462] | $21 - $266 | 199% |
| Ebms Contracted [320493] | $21 | 199% |
| Healthlink Contracted [320179] | $21 - $63 | 199% |
| Imagine 360 Contracted [320494] | $21 | 199% |
| Mercy Benefit Admin Contracted [320251] | $21 - $233 | 199% |
| Reflect Health Contracted [320492] | $21 | 199% |
| Yuzu Health Contracted [320521] | $21 | 199% |
| 90 Degree Benefits Contracted [320436] | $62 | 587% |
| Show-Me Health Administrators Contracted [320483] | $62 - $65 | 587% |
| Benefit Management Contracted [320052] | $164 | 1553% |
| Health Systems Inc Contracted [320174] | $164 | 1553% |
| Insurance System Inc Contracted [320465] | $164 | 1553% |
| Administrative Payor Contracted [320005] | $184 - $204 | 1742% |
| Evolutions Health Care Contracted [320124] | $184 | 1742% |
| Point C Contracted [320238] | $184 - $307 | 1742% |
| Point C [20238] | $184 | 1742% |
| Medical Destinations Contracted [320242] | $204 | 1932% |
| Workers Comp [20426] | $204 - $348 | 1932% |
| First Health Contracted [320128] | $229 | 2169% |
| Edison Health Solutions Contracted [320502] | $233 | 2206% |
| Federal Medical Center Contracted [320127] | $245 | 2320% |
| Multiplan Contracted [320270] | $315 | 2983% |
| Private Health Care Systems Contracted [320320] | $315 | 2983% |
| Compcare Of The Ozarks Contracted [320437] | $323 | 3059% |
| American Healthcare Alliance Contracted [320020] | $327 | 3097% |
| Qual Choice Contracted [320324] | $327 | 3097% |
| Municipal Health Plan Contracted [320271] | $331 | 3134% |
| Usa Managed Care Org Contracted [320429] | $360 | 3409% |
| Ppo Plus Contracted [320310] | $368 | 3485% |