CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Hillcrest Hospital Henryetta

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $290
Cash Discount Price: $109
vs. Medicare Baseline: 27.46x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Hillcrest Hospital Henryetta is $290. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $109. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 27.46x the Medicare baseline. Located in 2401 W Main, Henryetta, OK.

Cash / Self-Pay

$109

Average discount available for prompt cash payment at this facility.

Insurance Median

$290

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: $109 (1032%)

Insurance Median: $290 (2746%)

Cash: $109 (1032% of Medicare)

Ins. Median: $290 (2746% 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 2746% of the Medicare baseline (a markup of 2646%). 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
Black Lung [6055]	$91	862%
Lucent Health [6000]	$91	862%
Cigna	$199	1884%
Healthpartners [1500]	$199	1884%
National Association Of Letter Carriers [1695]	$199	1884%
Pba [1775]	$199	1884%
Global Health [1430]	$225	2131%
First Health [1375]	$246 - $312	2330%
Multiplan [1680]	$246 - $312	2330%
Healthcare Solutions [1485]	$258	2443%
Community Care [1290]	$290	2746%
Fmh Benefit Services [1390]	$290	2746%
Group Resources [1455]	$290	2746%
Phcs [1780]	$290 - $312	2746%
Healthsmart [1505]	$309	2926%
Administrative Concepts [1005]	$312	2955%
Allied Benefit Systems Inc [1030]	$312	2955%
Allied National Global Care [1035]	$312	2955%
Gilsbar [1425]	$312	2955%
Healthnet [1495]	$312	2955%
New Era Life Insurance Company [1705]	$312	2955%
Pan American Life Insurance Co [1770]	$312	2955%
Trustmark [2030]	$312	2955%
Pending Ssi [1616]	$363	3438%

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 $109.
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 Hillcrest Hospital Henryetta 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.