CMS Price Transparency Data
Blood test, comprehensive metabolic panel
Facility: Watsonville Community Hospital
Billing Code: 80053 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80053
- Insurance Median: $1,177
- Cash Discount Price: $1,279
- vs. Medicare Baseline: 111.46x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Watsonville Community Hospital is $1,177. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,279. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 111.46x the Medicare baseline. Located in 75 Nielson Street, Watsonville, CA.
Cash / Self-Pay
$1,279
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,177
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: $1,279 (12112%)
Insurance Median: $1,177 (11146%)
Cash: $1,279 (12112% of Medicare)
Ins. Median: $1,177 (11146% 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 11146% of the Medicare baseline (a markup of 11046%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Liberty Mutual Work Comp | $11 | 104% |
| Beta Healthcare Group | $11 | 104% |
| Secure Horizons Dign HMO | $11 - $426 | 104% |
| Health Net of California | $11 - $1,337 | 104% |
| Kemper Group Workers Comp | $11 | 104% |
| Secure Horizons | $11 | 104% |
| Ace-Usa | $11 | 104% |
| Travelers Insurance | $11 - $2,132 | 104% |
| Medicare (plans) | $11 | 104% |
| Alignment Health Plan | $11 | 104% |
| Blue Shield PPO | $11 - $34 | 104% |
| Gallagher Bassett Svcs | $11 | 104% |
| Crawford & Co | $11 | 104% |
| Fleming & Associates | $11 | 104% |
| Nx Health Network | $11 | 104% |
| UnitedHealthcare | $11 - $1,279 | 104% |
| Fireman's Fund Work Comp | $11 | 104% |
| Veterans Administration | $11 | 104% |
| Pinnacle Healthcare Uc | $11 | 104% |
| Workers Comp | $11 | 104% |
| Western Growers Work Comp | $11 | 104% |
| Tricare | $11 | 104% |
| Keenan & Assoc Work Comp | $11 | 104% |
| Miscellaneous Work Comp | $11 | 104% |
| U.S. Dept. of Labor | $11 | 104% |
| Republic Idemnity W/Comp | $11 | 104% |
| Hartford Workers' Comp | $11 | 104% |
| Medi-Cal E.R. | $13 | 123% |
| Medicaid / KanCare | $13 | 123% |
| California Childrens Srvs | $13 | 123% |
| Well Path | $13 - $2,132 | 123% |
| Ccs/Monterey County | $13 | 123% |
| Medi-Cal/Eds | $13 | 123% |
| Healthy Families | $13 - $34 | 123% |
| Alliance/Sccho | $14 | 133% |
| Cigna | $25 - $1,492 | 237% |
| Blue Shield HMO | $25 - $426 | 237% |
| Great-West/Phcs | $25 - $1,492 | 237% |
| Aetna | $25 - $1,748 | 237% |
| Health Net Pmg HMO | $25 - $1,337 | 237% |
| Blue Cross Blue Shield | $25 - $1,899 | 237% |
| Pacificare HMO | $25 - $1,279 | 237% |
| Bs Employee | $34 | 322% |
| Ufcw/Valley Clerks | $34 | 322% |
| United Agriculture | $34 | 322% |
| Delta Health Systems | $71 - $1,899 | 672% |
| Claims Management Wc | $71 - $1,899 | 672% |
| Western Growers Trust/Bc | $71 - $1,899 | 672% |
| Calif Ironworkers Field | $71 - $1,899 | 672% |
| Monterey Bay Pub Emp Trst | $71 - $1,899 | 672% |
| City of Wats/Pinnacle Clm | $71 - $1,899 | 672% |
| Laborers Health & Welfare | $71 - $1,899 | 672% |
| Carpenters H&W Trust | $71 - $1,899 | 672% |
| Robert Kennedy/Ccn | $71 - $1,899 | 672% |
| Sheet Metal Workers | $71 - $1,899 | 672% |
| Teamsters Benefit Trust | $71 - $1,899 | 672% |
| Operating Engineers | $71 - $1,899 | 672% |
| Pinnacle Claims Tpa/Bc | $71 - $1,899 | 672% |
| State Compensation Fund | $71 - $1,899 | 672% |
| Medicruz | $384 | 3636% |
| Victim Compensation Plan | $384 - $2,132 | 3636% |
| Western Health Advantage | $1,066 | 10095% |
| Self Pay | $1,279 | 12112% |
| Health Net Smartcare Netw | $1,279 | 12112% |
| Pacificare PPO | $1,279 | 12112% |
| Health Net Canopycare HMO | $1,337 | 12661% |
| Health Net Blue and Gold | $1,337 | 12661% |
| Transwestern | $1,492 - $1,705 | 14129% |
| Geha (Ccn) | $1,492 - $1,705 | 14129% |
| Adventist Risk Management | $1,492 - $1,705 | 14129% |
| First Health | $1,492 - $1,705 | 14129% |
| Multiplan Inc PPO | $1,663 | 15748% |
| Private Healthcare System | $1,663 | 15748% |
| Salinas Valley Mem Hops | $1,812 | 17159% |
| Coastal Healthcare Admin | $1,812 - $1,918 | 17159% |
| Apwu Health Plan | $2,132 | 20189% |
| Miscellaneous Insurance | $2,132 | 20189% |
| Wholesale Beer Distributo | $2,132 | 20189% |
| Allstate | $2,132 | 20189% |
| Aaa | $2,132 | 20189% |
| Sutter Health Plus | $2,132 | 20189% |
| United Administrative | $2,132 | 20189% |
| Aarp | $2,132 | 20189% |
| Prucare Pmg HMO | $2,132 | 20189% |
| Miscellaneous Auto | $2,132 | 20189% |
| Farmers Insurance | $2,132 | 20189% |
| North Calif Bakery Driver | $2,132 | 20189% |
| Physicians Mutual | $2,132 | 20189% |
| Zenith National Ins | $2,132 | 20189% |
| Prucare Pmg POS | $2,132 | 20189% |
| State Farm Ins | $2,132 | 20189% |
| Bankers Life & Casualty | $2,132 | 20189% |
| Humana | $2,132 | 20189% |