CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Good Samaritan Hospital of Suffern

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $73
Cash Discount Price: $168
vs. Medicare Baseline: 6.91x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Good Samaritan Hospital of Suffern is $73. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $168. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 6.91x the Medicare baseline. Located in 255 Lafayette Avenue, Suffern, NY.

Cash / Self-Pay

$168

Average discount available for prompt cash payment at this facility.

Insurance Median

$73

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: $168 (1591%)

Insurance Median: $73 (691%)

Cash: $168 (1591% of Medicare)

Ins. Median: $73 (691% 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 691% of the Medicare baseline (a markup of 591%). 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
Affinity By Molina McR	$11	104%
Mvp Gold (McR)	$11	104%
Hamaspik (McR)	$11	104%
Medicare (plans)	$11	104%
Tricare	$13	123%
Beacon Exchange	$13	123%
Beacon Commercial	$14	133%
Aetna	$18 - $20	170%
Cigna	$22 - $118	208%
Emblem Select Care (Exchange)	$27	256%
Emblem Ghi/Hip PPO	$31	294%
Geisinger Health Commercial/Exchange	$35	331%
Magnacare Preferred	$42	398%
Mvp Exchange	$46	436%
Self-Pay - Cc 30%	$50	473%
Blue Cross Blue Shield	$73 - $451	691%
Cdphp	$84	795%
Oxford Exchange	$84	795%
Self-Pay - Cc 50%	$84	795%
Mvp Hmo/Ppo	$89	843%
Magnacare Standard	$118	1117%
Oxford Commercial	$118	1117%
UnitedHealthcare	$118	1117%
PHCS	$126	1193%
Multiplan	$126	1193%
Emblem Ghi/Hip Hmo/Epo/Pos	$134	1269%
First Health	$143	1354%
Mvp	$1,478 - $1,742	13996%

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 $168.
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 Good Samaritan Hospital of Suffern 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.