CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Children's Nebraska

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $87
Cash Discount Price: Unavailable
vs. Medicare Baseline: 8.24x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Children's Nebraska is $87. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 8.24x the Medicare baseline. Located in 8200 Dodge St, Omaha, NE.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$87

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%)

Insurance Median: $87 (824%)

Ins. Median: $87 (824% 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 824% of the Medicare baseline (a markup of 724%). 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
Medicaid / KanCare	$10 - $135	95%
Molina (Iowa)	$10	95%
Wellpoint	$10	95%
Ambetter / Centene	$11	104%
Molina (Nebraska)	$16	152%
Midlands Choice Chi	$70 - $306	663%
UnitedHealthcare	$76 - $367	720%
Midlands Choice Elevate	$80 - $350	758%
Avera Health Plan	$85 - $371	805%
Centivo	$85 - $371	805%
Wellmark	$85 - $371	805%
Aetna	$88 - $385	833%
Midlands Choice	$88 - $385	833%
Sanford Health Plan	$88 - $385	833%
Blue Cross Blue Shield	$185 - $206	1752%

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 $X.
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 Children's Nebraska 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.