CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Oak Valley Hospital District

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $633
Cash Discount Price: $819
vs. Medicare Baseline: 59.94x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Oak Valley Hospital District is $633. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $819. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 59.94x the Medicare baseline. Located in 350 S Oak Ave, Oakdale, CA.

Cash / Self-Pay

$819

Average discount available for prompt cash payment at this facility.

Insurance Median

$633

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: $819 (7756%)

Insurance Median: $633 (5994%)

Cash: $819 (7756% of Medicare)

Ins. Median: $633 (5994% 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 5994% of the Medicare baseline (a markup of 5894%). 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
Alignment Op Only Ip/Op Only-All Plans	$11	104%
Humana	$11	104%
Kaiser Mcr Adv Ip/Op Only	$11	104%
Scan Health Plan Ip/Op Only-All Plans	$11	104%
Blue Cross Blue Shield	$12 - $983	114%
Healthnet Medi-Cal Ip/Op Only	$12	114%
Imperial Health Ip/Op Only-All Plans	$12	114%
Kaiser Medi-Cal Ip/Op Only	$12	114%
Medi-Cal Ip/Op Only	$12	114%
Hp Of San Joaquin Ip/Op Only-All Plans	$15	142%
Blue Shield Epn Ip/Op Only	$591	5597%
Healthnet Comm Op Only Ip/Op Only-All Other Plans	$633	5994%
Kaiser Comm Ip/Op Only-All Other Plans	$677	6411%
Blue Shield/Bcout Ip/Op Only-All Other Plans	$721	6828%
Cigna	$732	6932%
UnitedHealthcare	$764	7235%
Aetna	$929	8797%

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 $819.
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 Oak Valley Hospital District 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.