Blood test, comprehensive metabolic panel
Facility: Johnson Memorial Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $22
- Cash Discount Price: $117
- vs. Medicare Baseline: 2.08x 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 208% of the Medicare baseline (a markup of 108%). 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 |
|---|---|---|
| Medicare (plans) | $10 - $164 | 95% |
| Blue Cross Blue Shield | $10 - $156 | 95% |
| UnitedHealthcare | $10 - $156 | 95% |
| Aetna | $10 - $156 | 95% |
| Harvard Pilgrim Healthcare | $11 | 104% |
| Cca Senior Care Options | $11 - $159 | 104% |
| Cigna | $11 - $161 | 104% |
| Geha | $11 | 104% |
| Centivo | $13 - $372 | 123% |
| Fallon Health | $14 - $207 | 133% |
| Connecticare | $18 - $20 | 170% |
| Gravie Admin Services | $21 | 199% |
| Hap | $21 | 199% |
| 1199 National Benefit Fund | $21 | 199% |
| Meritain | $21 | 199% |
| Nippon Life Ins | $21 | 199% |
| Webtpa | $21 | 199% |
| Luminare Health | $21 | 199% |
| Allied Benefit Systems | $21 | 199% |
| Pre-Employment | $22 | 208% |
| Blue Shield - PA (Highmark) | $22 | 208% |
| Bcn Domestic | $22 | 208% |
| Wc Domestic | $22 | 208% |
| Blue Distinction Transplant | $22 | 208% |
| Blue Benefit Administrators of Massachusetts | $22 | 208% |
| Blue Shield - Wa (Regence) | $22 | 208% |
| Unicare | $22 | 208% |
| Kaiser Domestic | $22 | 208% |
| Innovative Health Plan II | $22 - $335 | 208% |
| Blue Shield - Id (Regence) | $22 | 208% |
| Wellpoint | $22 | 208% |
| Blue Shield - Ny Highmark Western | $22 | 208% |
| Claimdoc | $22 - $335 | 208% |
| Blue Shield - Ny Highmark Northeastern | $22 | 208% |
| Blue Shield - Ca | $22 | 208% |
| Diversified Administrators | $22 - $335 | 208% |
| Blue Care Network | $22 | 208% |
| Health Choices | $22 | 208% |
| Connecticut Dept of Correction | $25 - $147 | 237% |
| Health New England | $49 | 464% |
| Prime Health Services | $60 | 568% |
| Health Partners | $60 | 568% |
| Magnacare | $60 | 568% |
| Allegiance | $60 | 568% |
| Trinity Health Share | $62 | 587% |
| Allied National Global Care | $62 | 587% |
| Lifetime Benefit Solutions | $62 | 587% |
| Pan-American Life | $62 | 587% |
| Mvp | $62 | 587% |
| Family Life Insurance Company | $62 | 587% |
| Asrm - Reliance Standard Life Insurance | $62 | 587% |
| Multiplan | $62 | 587% |
| Christian Care Ministry | $62 | 587% |
| International Benefit Administrators | $62 | 587% |
| Dean Health | $62 | 587% |
| Medi Share | $62 | 587% |
| Paramount HMO | $62 | 587% |
| Manhattan Life | $62 | 587% |
| Pai | $62 | 587% |
| Ghc Scw | $62 | 587% |
| PHCS | $62 | 587% |
| Health Smart | $64 | 606% |
| United Behavioral Health Eap | $75 | 710% |