CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Saint Agnes Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $29
  • Cash Discount Price: $336
  • vs. Medicare Baseline: 2.75x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Saint Agnes Medical Center is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $336. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 2.75x the Medicare baseline. Located in 1303 E Herndon Ave, Fresno, CA.
Cash / Self-Pay
$336

Average discount available for prompt cash payment at this facility.

Insurance Median
$29

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: $336 (3182%)
Insurance Median: $29 (275%)
Cash: $336 (3182% of Medicare)
Ins. Median: $29 (275% 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 275% of the Medicare baseline (a markup of 175%). 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.

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
Aetna $10 - $64 95%
Blue Cross Blue Shield $10 - $99 95%
Humana $10 - $11 95%
Medicare (plans) $10 - $11 95%
UnitedHealthcare $11 - $21 104%
Welbe Health $11 104%
Align Senior Care $12 114%
Correctcare Integrated Health $13 123%
Medi-Cal Healthnet $14 - $16 133%
Geha $18 170%
Kaiser Permanente $18 170%
Advantek Central Usd $26 246%
Blue Shield - Ca $30 - $99 284%
Meritain $60 568%
Trustmark Small Business Benefits $60 568%
Allied Benefit Systems $64 606%
Boon Chapman $64 606%
Hap $64 606%
Webtpa $64 606%
Blue Benefit Administrators Of Massachusetts $99 938%
Blue Care Network $99 938%
Blue Distinction Transplant $99 938%
Blue Shield - Id (Regence) $99 938%
Blue Shield - Ny Highmark Northeastern $99 938%
Blue Shield - Ny Highmark Western $99 938%
Blue Shield - Pa (Highmark) $99 938%
Blue Shield - Wa (Regence) $99 938%
St Agnes Nicu Valley Childrens Hospital $110 1042%
Healthnet $115 - $138 1089%
Coventry $116 1098%
Cba Network By Design $127 1203%
Network Health $127 1203%
Allegiance $130 1231%
American Postal Workers Secondary $130 1231%
Cigna $130 1231%
Multiplan $142 1345%
Phcs $142 1345%
Interplan $152 1439%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1303 E Herndon Ave, Fresno, CA 93720
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals