CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Lafayette Regional Health Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $484
Cash Discount Price: $1,126
vs. Medicare Baseline: 45.83x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Lafayette Regional Health Center is $484. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,126. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 45.83x the Medicare baseline. Located in 1500 State Street, Lexington, MO.

Cash / Self-Pay

$1,126

Average discount available for prompt cash payment at this facility.

Insurance Median

$484

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: $1,126 (10663%)

Insurance Median: $484 (4583%)

Cash: $1,126 (10663% of Medicare)

Ins. Median: $484 (4583% 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 4583% of the Medicare baseline (a markup of 4483%). 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	$10 - $986	95%
Amerigroup	$11	104%
Healthyblue	$11	104%
Home State Health Plan	$11	104%
Medicaid / KanCare	$11	104%
Unicare	$11	104%
United	$11 - $507	104%
Corvel Corporation	$23 - $957	218%
Oha Network	$23 - $563	218%
Ambetter / Centene	$209	1979%
Nhc Advantage	$214	2027%
Universal Healthcare	$293	2775%
Humana	$381 - $484	3608%
Blue Cross Blue Shield	$428 - $1,126	4053%
College Park Family Care Center	$484	4583%
Oscar	$563	5331%
Cigna	$643 - $804	6089%
Wppa Providrs Care Network	$845	8002%
Multiplan	$879	8324%
Coventry	$899	8513%
Coventry Kc Mo	$899	8513%
Cco, Inc.	$957	9063%
Focus Healthcare Mgmt, Inc	$1,014	9602%

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 $1,126.
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 Lafayette Regional Health Center 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.