CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Riverside Community Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $12
Cash Discount Price: $2,266
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Riverside Community Hospital is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,266. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.14x the Medicare baseline. Located in 4445 Magnolia Avenue, Riverside, CA.

Cash / Self-Pay

$2,266

Average discount available for prompt cash payment at this facility.

Insurance Median

$12

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: $2,266 (21458%)

Insurance Median: $12 (114%)

Cash: $2,266 (21458% of Medicare)

Ins. Median: $12 (114% 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.

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
Bristol Hospice	$8	76%
Aetna	$10 - $408	95%
Alignment Health Plan	$11	104%
Blue Cross Blue Shield	$11 - $55	104%
Blue Shield	$11 - $116	104%
Brand New Day	$11 - $13	104%
Care1St Health Plan	$11	104%
Central Health Plan	$11	104%
Clever Care Of Golden State	$11	104%
Easy Choice Health Plan	$11	104%
Health Net	$11 - $505	104%
Heritage Provider Network	$11 - $14	104%
Humana	$11	104%
Redlands Community Hospital	$11	104%
Riverside Medical Clinic	$11 - $13	104%
Riverside Physician	$11	104%
Scan Health Plan	$11	104%
Triwest Healthcare Alliance	$11	104%
United	$11 - $596	104%
UnitedHealthcare	$11	104%
Corvel Corporation	$12	114%
Healthsmart	$12 - $1,813	114%
La Care Health	$12	114%
Molina	$12	114%
Next	$12 - $1,813	114%
Inland Empire Health Plan	$17 - $18	161%
Bright Health	$26	246%
Cigna	$29	275%
Medcare Partners	$340	3220%
First Health	$997 - $2,040	9441%
American Health System	$1,020	9659%
Multiplan	$1,813 - $1,926	17169%

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 $2,266.
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 Riverside Community Hospital 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.