CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: McAlester Regional Health Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $76
Cash Discount Price: $55
vs. Medicare Baseline: 7.20x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at McAlester Regional Health Center is $76. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $55. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 7.20x the Medicare baseline. Located in One Clark Bass Boulevard, McAlester, OK.

Cash / Self-Pay

$55

Average discount available for prompt cash payment at this facility.

Insurance Median

$76

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: $55 (521%)

Insurance Median: $76 (720%)

Cash: $55 (521% of Medicare)

Ins. Median: $76 (720% 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 720% of the Medicare baseline (a markup of 620%). 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	$11	104%
Blue Cross Blue Shield	$11	104%
Choctaw Nation	$11	104%
Global Health	$11 - $20	104%
Coventry	$66 - $171	625%
Okla Health Network	$70 - $163	663%
Osma Health	$72 - $169	682%
Preferred Choice Community	$72 - $169	682%
Phcs	$74 - $173	701%
Beech Street	$76 - $179	720%
Cigna	$76 - $179	720%
Geha	$77 - $180	729%

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 $55.
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 McAlester 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.