CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Mercy Hospital - Cassville

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $223
Cash Discount Price: $181
vs. Medicare Baseline: 21.12x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Mercy Hospital - Cassville is $223. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $181. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 21.12x the Medicare baseline. Located in 94 Main Street, Cassville, MO.

Cash / Self-Pay

$181

Average discount available for prompt cash payment at this facility.

Insurance Median

$223

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: $181 (1714%)

Insurance Median: $223 (2112%)

Cash: $181 (1714% of Medicare)

Ins. Median: $223 (2112% 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 2112% of the Medicare baseline (a markup of 2012%). 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
Aetna	$9 - $248	85%
Humana	$9 - $237	85%
Medicaid / KanCare	$9 - $145	85%
Blue Cross Blue Shield	$10 - $271	95%
Medicare (plans)	$11 - $120	104%
UnitedHealthcare	$15 - $265	142%
Dept Of Veteran Affairs Contracted [320106]	$95	900%
Tricare	$113	1070%
Cherokee Nation Health Serv Contracted [320066]	$115	1089%
Cigna	$115 - $265	1089%
Cross Timbers Hospice [20098]	$115	1089%
Elara Caring Aspire Hospice [20433]	$115	1089%
Globalhealth Contracted [320145]	$115	1089%
Halo Hcr Inc Hospice Contracted [320432]	$115	1089%
Halo Hcr Inc Hospice [20432]	$115	1089%
Indian Health Service Contracted [320198]	$115	1089%
Kindful Hospice Contracted [320434]	$115	1089%
Kindful Hospice [20434]	$115	1089%
Medical Associates Health Contracted [320444]	$115	1089%
Mercy Hospice Okc [20252]	$115	1089%
Mercy Mgd Behavioral Health Contracted [320259]	$115	1089%
Pace Of The Ozarks Contracted [320518]	$115	1089%
Provider Partners Health Plans Contracted [320450]	$115	1089%
Qual Choice Contracted [320325]	$115	1089%
Healthscope Contracted [320182]	$117	1108%
Administrative Payor Contracted [320005]	$126	1193%
Centivo Contracted [320505]	$142	1345%
Ambetter / Centene	$145	1373%
Home State Health Plan Contracted [320187]	$145	1373%
Novasys Contracted [320285]	$145	1373%
Healthlink Contracted [320179]	$181 - $251	1714%
Preferred Health Plan Contracted [320522]	$181	1714%
Health Systems Inc Contracted [320174]	$223	2112%
Insurance System Inc Contracted [320465]	$223	2112%
Point C Contracted [320238]	$223 - $251	2112%
Point C [20238]	$223	2112%
United Medical Resources Contracted [320454]	$223 - $237	2112%
Workers Comp [20426]	$223 - $251	2112%
Municipal Health Plan Contracted [320271]	$226	2140%
Medica Contracted [320239]	$250	2367%
90 Degree Benefits Contracted [320436]	$251	2377%
Aither Health Contracted [320449]	$251	2377%
American Healthcare Alliance Contracted [320020]	$251	2377%
Auxiant Contracted [320462]	$251	2377%
Benefit Management Contracted [320052]	$251	2377%
Ebms Contracted [320493]	$251	2377%
Edison Health Solutions Contracted [320502]	$251	2377%
Evolutions Health Care Contracted [320124]	$251	2377%
Imagine 360 Contracted [320494]	$251	2377%
Mercy Benefit Admin Contracted [320251]	$251	2377%
Reflect Health Contracted [320492]	$251	2377%
Show-Me Health Administrators Contracted [320483]	$251	2377%
Usa Managed Care Org Contracted [320429]	$251	2377%
Yuzu Health Contracted [320521]	$251	2377%
First Health Contracted [320128]	$265	2509%
Multiplan Contracted [320270]	$265	2509%
Private Health Care Systems Contracted [320320]	$265	2509%

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 $181.
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 Mercy Hospital - Cassville 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.