CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: St Francis Memorial Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $131
Cash Discount Price: $273
vs. Medicare Baseline: 12.41x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at St Francis Memorial Hospital is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $273. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 12.41x the Medicare baseline. Located in 430 North Monitor St, West Point, NE.

Cash / Self-Pay

$273

Average discount available for prompt cash payment at this facility.

Insurance Median

$131

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: $273 (2585%)

Insurance Median: $131 (1241%)

Cash: $273 (2585% of Medicare)

Ins. Median: $131 (1241% 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 1241% of the Medicare baseline (a markup of 1141%). 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
Nebraska Total Care	$104 - $123	985%
UnitedHealthcare	$104 - $262	985%
Molina Healthcare Of Nebraska	$106 - $136	1004%
Blue Cross Blue Shield	$120 - $259	1136%
Humana	$120	1136%
Medica	$120 - $262	1136%
Aetna	$126 - $262	1193%
Good Samaritan Insurance Plan Of Nebraska	$126	1193%
Midlands Choice	$262	2481%

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 $273.
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 St Francis Memorial Hospital 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.