Blood test, comprehensive metabolic panel
Facility: Licking Memorial Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $260
- Cash Discount Price: $361
- vs. Medicare Baseline: 24.62x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 2462% of the Medicare baseline (a markup of 2362%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Tricare | $10 | 95% |
| UnitedHealthcare | $11 - $307 | 104% |
| Cigna | $11 - $325 | 104% |
| Champva [500001] | $11 | 104% |
| Medicare (plans) | $11 | 104% |
| Humana | $11 - $350 | 104% |
| Blue Cross Blue Shield | $11 - $310 | 104% |
| Wellcare By Allwell [450104] | $11 | 104% |
| Veterans Administration [100068] | $11 | 104% |
| Aetna | $11 - $262 | 104% |
| Molina Marketplace [100106] | $17 | 161% |
| Medical Mutual [100114] | $198 - $299 | 1875% |
| Medben [700068] | $252 - $353 | 2386% |
| Geha [100039] | $260 | 2462% |
| Allied Benefit Systems [100015] | $260 | 2462% |
| Meritain [100063] | $260 | 2462% |
| Optima [700069] | $260 | 2462% |
| Webtpa [100127] | $260 | 2462% |
| Trustmark Small Business Benefits [100263] | $260 | 2462% |
| Gravie Administrative Services [100165] | $260 | 2462% |
| Benicomp [70090] | $270 | 2557% |
| Consociate Health [100029] | $288 | 2727% |
| Consociate Health 6 Degrees [100059] | $288 | 2727% |
| Healthscope [100157] | $307 | 2907% |
| United Medical Resources [700071] | $307 | 2907% |
| Surest [100016] | $307 | 2907% |
| The Health Plan [100261] | $325 | 3078% |
| Ohio Healthy [100255] | $325 | 3078% |
| National Association of Letter Carriers [100067] | $325 | 3078% |
| American Postal Workers [100089] | $325 | 3078% |
| Wellfleet Group, LLC [100164] | $325 | 3078% |
| Osu Prime Care [100254] | $325 | 3078% |
| Antidote Health Plan of Ohio [70006803] | $325 | 3078% |
| Ohio Healthy Luminare Health [100264] | $325 | 3078% |
| Great West Life [700064] | $325 | 3078% |
| Ohio PPO Connect [70006801] | $325 | 3078% |
| Coresource [100002] | $325 - $361 | 3078% |
| Quality Care Partners [70006802] | $325 | 3078% |
| Pan American Life [700070] | $333 | 3153% |
| Coventry [100010] | $333 | 3153% |
| Ohio Health Choice [100109] | $346 | 3277% |
| Philadelphia American Life [100260] | $350 - $361 | 3314% |
| Carefactor [100087] | $350 | 3314% |
| Administrative Concepts [100006] | $350 | 3314% |
| Reliance Standard-Asrm [100258] | $350 | 3314% |