CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: City of Hope National Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $203
Cash Discount Price: $290
vs. Medicare Baseline: 19.22x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at City of Hope National Medical Center is $203. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $290. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 19.22x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.

Cash / Self-Pay

$290

Average discount available for prompt cash payment at this facility.

Insurance Median

$203

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: $290 (2746%)

Insurance Median: $203 (1922%)

Cash: $290 (2746% of Medicare)

Ins. Median: $203 (1922% 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 1922% of the Medicare baseline (a markup of 1822%). 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
Health Net	$7 - $281	66%
Cal Optima	$11 - $17	104%
Heritage Provider Network	$11 - $203	104%
Inland Empire	$13 - $232	123%
Facey	$14	133%
Prime Healthcare Keenan	$18 - $279	170%
UnitedHealthcare	$32 - $162	303%
Healthcare Partners	$36	341%
Blue Cross Blue Shield	$106 - $203	1004%
Blue Shield	$172 - $374	1629%
Blue Shield Covca	$176	1667%
Blue Shield Promise	$203	1922%
Cencal	$232	2197%
La Care Health	$232	2197%
Kaiser	$261	2472%
Aetna	$290	2746%
Gold Coast	$290	2746%
Molina	$290 - $377	2746%
Cigna	$312	2955%
St. Joseph Heritage	$348	3295%
Primecare Medical Network	$377	3570%
First Health	$447	4233%
Phcs Multiplan	$522	4943%

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 $290.
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 City of Hope National Medical Center 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.