CMS Price Transparency Data
Blood test, comprehensive metabolic panel
Facility: AHMC Anaheim Regional Medical Center
Billing Code: 80053 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80053
- Insurance Median: $12
- Cash Discount Price: $441
- vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at AHMC Anaheim Regional Medical Center is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $441. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.14x the Medicare baseline. Located in 1111 W La Palma Avenue, Anaheim, CA.
Cash / Self-Pay
$441
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: $441 (4176%)
Insurance Median: $12 (114%)
Cash: $441 (4176% 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.
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 |
|---|---|---|
| Veterans Administration | $7 | 66% |
| Affiliated Doctors Of Orange County | $8 | 76% |
| Ahmc Reciprocity Agreement | $9 - $132 | 85% |
| Allied Physicians | $9 - $16 | 85% |
| Altamed Health Network | $9 - $10 | 85% |
| Applecare Medical Group | $9 | 85% |
| Beverly Hospital | $9 - $12 | 85% |
| Brand New Day | $9 - $13 | 85% |
| Health Net | $9 | 85% |
| Healthcare Partners | $9 - $10 | 85% |
| Healthy Way La | $9 | 85% |
| Heritage Provider Network | $9 - $14 | 85% |
| Kaiser Foundation Hospitals | $9 - $10 | 85% |
| Medical Safety Net Program | $9 | 85% |
| Non Contracted Medi-Cal | $9 | 85% |
| Talbert Medical Group | $9 - $11 | 85% |
| Aetna | $10 - $58 | 95% |
| Aids Health Foundation | $10 - $11 | 95% |
| Alignment Health Plan | $10 | 95% |
| Alta Los Angeles Hospital | $10 | 95% |
| Apa Aco Inc | $10 | 95% |
| Avanti | $10 - $13 | 95% |
| Blue Cross Blue Shield | $10 - $39 | 95% |
| Caloptima | $10 - $13 | 95% |
| Central Health Of California | $10 | 95% |
| Davita Heatlhcare Partners Plan Inc | $10 - $238 | 95% |
| Healthnet | $10 | 95% |
| Humana | $10 | 95% |
| Medicare (plans) | $10 - $220 | 95% |
| Monarch Health Plan | $10 - $299 | 95% |
| Pacificare | $10 | 95% |
| Prospect Health Plan | $10 - $14 | 95% |
| Prospect Medical Group | $10 | 95% |
| Scan Health Plan | $10 | 95% |
| Seoul Medical Group | $10 - $11 | 95% |
| Wellcare | $10 | 95% |
| Align Senior Care | $11 | 104% |
| Angels Baseball Workers Comp | $11 | 104% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $11 | 104% |
| Emanate Health | $11 - $13 | 104% |
| Health Net Inc | $11 - $339 | 104% |
| Healthnet Cal Optima Medi-Cal/Healthy Families | $11 | 104% |
| Hollywood Presbyterian Advanced Med Mgmt Mcal | $11 | 104% |
| Hollywood Presbyterian Medpoint Mcal | $11 | 104% |
| Innovative Integrated Health (Iih)/Orange County Pace | $11 | 104% |
| Interplan | $11 - $309 | 104% |
| Medi-Cal | $11 | 104% |
| Memorial Healthcare Ipa/Cap/Valuation Rates | $11 | 104% |
| Nchp | $11 | 104% |
| Private Pay Flat Rate | $11 | 104% |
| Self-Pay | $11 | 104% |
| Tricare | $11 | 104% |
| Cigna | $12 - $13 | 114% |
| First Health | $12 - $375 | 114% |
| Orange County Preferred Provider Organization | $12 - $331 | 114% |
| Ahmc Health Self-Insurance Epo | $13 | 123% |
| Athens Administrators | $13 | 123% |
| Capp Care | $13 - $331 | 123% |
| Corvel | $13 - $331 | 123% |
| Knox-Keene Act | $13 | 123% |
| Marriot Intl | $13 | 123% |
| Non Contracted Workers Comp | $13 | 123% |
| UnitedHealthcare | $21 - $42 | 199% |
| Monarch Healthcare Medical Group | $26 | 246% |
| Msi/Medical Services For Indigents | $52 | 492% |
| Netcare Life And Health Insurance | $110 | 1042% |
| Blue Shield Of California | $125 - $142 | 1184% |
| Advance Clinical Research Institute | $132 | 1250% |
| Memorial Healthcare Ipa | $132 | 1250% |
| Medical Acquisition Company | $176 | 1667% |
| Healthcare Partners Commercial | $238 | 2254% |
| Huntington Memorial Hospital | $238 | 2254% |
| Genesis Healthcare Ipa Ancillary | $265 | 2509% |
| Affiliated Health Fund | $309 | 2926% |
| Allnet Preferred Provider | $309 | 2926% |
| Care First | $309 | 2926% |
| Private Healthcare Systems | $309 | 2926% |
| Choicecare | $331 | 3134% |
| Multiplan Inc | $331 | 3134% |
| National Provider Network | $353 | 3343% |
| Three Rivers Providers Network | $353 | 3343% |
| Health Payors Organization | $397 | 3759% |
| Non Contracted Commercial | $441 | 4176% |