CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Mercy Hospital Lincoln

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $129
Cash Discount Price: $177
vs. Medicare Baseline: 12.22x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Mercy Hospital Lincoln is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $177. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 12.22x the Medicare baseline. Located in 1000 East Cherry Street, Troy, MO.

Cash / Self-Pay

$177

Average discount available for prompt cash payment at this facility.

Insurance Median

$129

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: $177 (1676%)

Insurance Median: $129 (1222%)

Cash: $177 (1676% of Medicare)

Ins. Median: $129 (1222% 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 1222% of the Medicare baseline (a markup of 1122%). 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
United Medical Resources Contracted [320454]	$11	104%
UnitedHealthcare	$11 - $64	104%
Blue Cross Blue Shield	$12 - $129	114%
Medicaid / KanCare	$13 - $125	123%
Cigna	$14 - $68	133%
Healthlink Contracted [320179]	$15 - $231	142%
Aetna	$41 - $178	388%
Tricare	$58	549%
Medicare (plans)	$59 - $272	559%
American Health Advantage Of Mo Mcr [10473]	$64	606%
Cherokee Nation Health Serv Contracted [320066]	$64	606%
Cross Timbers Hospice [20098]	$64	606%
Dept Of Veteran Affairs Contracted [320106]	$64	606%
Elara Caring Aspire Hospice Contracted [320433]	$64	606%
Elara Caring Aspire Hospice [20433]	$64	606%
Globalhealth Contracted [320145]	$64	606%
Halo Hcr Inc Hospice Contracted [320432]	$64	606%
Halo Hcr Inc Hospice [20432]	$64	606%
Humana	$64 - $245	606%
Indian Health Service Contracted [320198]	$64	606%
Kindful Hospice Contracted [320434]	$64	606%
Kindful Hospice [20434]	$64	606%
Mercy Hospice Okc [20252]	$64	606%
Pace Of The Ozarks Contracted [320518]	$64	606%
Provider Partners Health Plans Contracted [320450]	$64	606%
Qual Choice Contracted [320325]	$64	606%
Centivo Contracted [320505]	$99	938%
Medica Contracted [320239]	$114	1080%
Ambetter / Centene	$125	1184%
Home State Health Plan Contracted [320187]	$125	1184%
Novasys Contracted [320285]	$125	1184%
Hope Trust Contracted [320488]	$135	1278%
Health Choices Contracted [320448]	$163	1544%
Health Choices [20448]	$163	1544%
Medical Associates Health Contracted [320444]	$163	1544%
First Health Contracted [320128]	$178 - $204	1686%
Mercy Mgd Behavioral Health Contracted [320259]	$204	1932%
Multiplan Contracted [320270]	$204	1932%
Private Health Care Systems Contracted [320320]	$204	1932%
Workers Comp [20426]	$204 - $218	1932%
Aither Health Contracted [320449]	$231	2188%
Aither Health [20449]	$231	2188%
Auxiant Contracted [320462]	$231	2188%
Ebms Contracted [320493]	$231	2188%
Edison Health Solutions Contracted [320502]	$231	2188%
Federal Medical Center Contracted [320127]	$231	2188%
Imagine 360 Contracted [320494]	$231	2188%
Insurance System Inc Contracted [320465]	$231	2188%
Mercy Benefit Admin Contracted [320251]	$231	2188%
Mercy Benefit Admin [20251]	$231	2188%
Point C Contracted [320238]	$231	2188%
Preferred Health Plan Contracted [320522]	$231	2188%
Reflect Health Contracted [320492]	$231	2188%
Show-Me Health Administrators Contracted [320483]	$231	2188%
Tri State Healthcare Coalition Contracted [320379]	$231	2188%
Yuzu Health Contracted [320521]	$231	2188%

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 $177.
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 Lincoln 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.