CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Baldwin Health

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $15
  • Cash Discount Price: $156
  • vs. Medicare Baseline: 1.42x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Baldwin Health is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $156. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.42x the Medicare baseline. Located in 1613 North McKenzie Street, Foley, AL.
Cash / Self-Pay
$156

Average discount available for prompt cash payment at this facility.

Insurance Median
$15

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: $156 (1477%)
Insurance Median: $15 (142%)
Cash: $156 (1477% of Medicare)
Ins. Median: $15 (142% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
First Choice $6 57%
Medicaid / KanCare $7 66%
Bc Pml $9 85%
Node Champva $9 85%
Tricare $9 85%
Blue Cross Blue Shield $10 - $11 95%
Humana $10 95%
Medicare (plans) $10 95%
Triwest $10 95%
UnitedHealthcare $10 - $11 95%
Windsor Health Plan $10 95%
Aetna $11 - $586 104%
Al Bccedp $11 104%
Cigna $11 - $44 104%
Community Hospice $11 104%
Hospice $11 104%
Mercy Medical Hospice $11 104%
Node Clover Health Mcr Adv $11 104%
Node Devoted Health Mcr Adv $11 104%
Node Va $11 104%
Node Wellcare Mcr Adv $11 104%
Select Health $11 104%
Veterans Eval Services $11 104%
Us Dol $13 123%
Ambetter / Centene $16 152%
Self Pay $117 - $195 1108%
American Employee Alliance $261 2472%
Multiplan $371 - $534 3513%
First Health $489 - $526 4631%
Alamed $498 4716%
Multiplan Inc $498 4716%
Coventry Work Comp Al $509 4820%
One Health $521 4934%
Pro America $521 4934%
Novanet $526 4981%
Alabama Wc $554 5246%
Gulf Health $554 5246%
Principal Ppo $554 5246%
Viva Health $554 5246%
National Health $586 5549%
Galaxy $593 5616%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1613 North McKenzie Street, Foley, AL 36535
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals