CMS Price Transparency Data
Blood test, comprehensive metabolic panel
Facility: San Gabriel Valley Medical Center
Billing Code: 80053 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80053
- Insurance Median: $13
- Cash Discount Price: $308
- vs. Medicare Baseline: 1.23x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at San Gabriel Valley Medical Center is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $308. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.23x the Medicare baseline. Located in 438 W Las Tunas Drive, San Gabriel, CA.
Cash / Self-Pay
$308
Average discount available for prompt cash payment at this facility.
Insurance Median
$13
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: $308 (2917%)
Insurance Median: $13 (123%)
Cash: $308 (2917% of Medicare)
Ins. Median: $13 (123% 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Veterans Administration | $7 | 66% |
| Ahmc Medi-Cal Reciprocity | $9 | 85% |
| Allied Physicians | $9 - $16 | 85% |
| Altamed Health Network | $9 - $10 | 85% |
| Beverly Hospital | $9 - $12 | 85% |
| Brand New Day | $9 - $359 | 85% |
| Emanate Health | $9 - $13 | 85% |
| Healthnet Medi-Cal Non-Contract | $9 | 85% |
| Healthy Way La | $9 | 85% |
| Non Contracting Medi Cal | $9 | 85% |
| Aetna | $10 - $18 | 95% |
| Alignment Health Plan | $10 | 95% |
| Apa/Aco Inc | $10 | 95% |
| Avanti | $10 - $13 | 95% |
| Blue Cross Blue Shield | $10 - $51 | 95% |
| Blue Shield Of California | $10 - $149 | 95% |
| Central Health Plan | $10 - $616 | 95% |
| Health Net | $10 - $596 | 95% |
| Health Net Inc | $10 - $25 | 95% |
| Humana | $10 | 95% |
| La Care Health Plan | $10 - $11 | 95% |
| Medicare (plans) | $10 | 95% |
| Molina Healthcare Of California | $10 - $400 | 95% |
| Pacific Alliance Medical Center | $10 | 95% |
| Pacificare Of California | $10 - $336 | 95% |
| Providence Health Network | $10 | 95% |
| Tricare | $10 | 95% |
| Wellcare | $10 | 95% |
| Aids Healthcare Foundation | $11 - $410 | 104% |
| Cv-19 Hrsa Uninsured Testing And Tx | $11 | 104% |
| Hollywood Presbyterian Adv Med Mcal | $11 | 104% |
| Hollywood Presbyterian Medpoint Mcal | $11 | 104% |
| Inter Valley Health Plan | $11 | 104% |
| Medicaid / KanCare | $11 | 104% |
| Physicians Healthways | $11 | 104% |
| Self-Pay | $11 | 104% |
| St Vincent Medical Center/Psych | $11 | 104% |
| Chinatown Service Center Pace | $12 | 114% |
| Cigna | $12 | 114% |
| Ahmc Health Self-Insurance Epo | $13 | 123% |
| Athens Administrators | $13 | 123% |
| Beech Street | $13 - $821 | 123% |
| Care 1St Health Plan | $13 - $667 | 123% |
| Knox-Keene Act | $13 | 123% |
| Other Non Contracting Workers Comp | $13 | 123% |
| UnitedHealthcare | $21 - $42 | 199% |
| Private Pay | $31 | 294% |
| Ahmc Reciprocity | $308 | 2917% |
| Alignment Healthplan | $359 | 3400% |
| Clever Care | $359 | 3400% |
| Pacific Independent Physician Associates | $410 | 3883% |
| Facey Medical | $513 | 4858% |
| Community Care Network | $667 | 6316% |
| Choicecare Network | $718 | 6799% |
| Private Healthcare Systems (Phcs) | $718 | 6799% |
| Affiliated Health Fund | $770 | 7292% |
| Multiplan | $923 | 8741% |
| Ppo Next | $923 | 8741% |
| Managed Health Network | $1,026 | 9716% |
| Medi-Cal Sub Acute | $1,026 | 9716% |
| One Legacy | $1,026 | 9716% |
| Other Non Contracted Commercial | $1,026 | 9716% |
| Us Behavioral Health Plan | $1,026 | 9716% |