CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Adventist Health Ukiah Valley

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $120
Cash Discount Price: $45
vs. Medicare Baseline: 11.36x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Adventist Health Ukiah Valley is $120. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 11.36x the Medicare baseline. Located in 275 Hospital Drive, Ukiah, CA.

Cash / Self-Pay

$45

Average discount available for prompt cash payment at this facility.

Insurance Median

$120

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: $45 (426%)

Insurance Median: $120 (1136%)

Cash: $45 (426% of Medicare)

Ins. Median: $120 (1136% 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 1136% of the Medicare baseline (a markup of 1036%). 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
Blue Shield Epn-All Other Plans	$5 - $119	47%
Blue Shield Non-Epn	$5 - $120	47%
Healthnet-All Plans	$7 - $178	66%
Western Growers-All Plans	$7 - $162	66%
Mendocino Lcc District-All Plans	$8 - $203	76%
Cigna	$10 - $243	95%
Foundation For Medical Care-All Plans	$10 - $234	95%
Interplan-All Plans	$10 - $256	95%
Kaiser-All Other Plans	$10 - $250	95%
Networks By Design-All Plans	$10 - $250	95%
Phcs Multiplan-All Plans	$10 - $250	95%
UnitedHealthcare	$10 - $261	95%
Beech Street-All Plans	$11 - $265	104%
Blue Shield Mcr Adv	$11	104%
Choice Care-All Plans	$11 - $265	104%
Health Mgmt Network-All Plans	$11 - $265	104%
Kaiser Mcr Adv	$11	104%
Three Rivers-All Plans	$11 - $281	104%
Tricare	$11	104%
Kaiser Medi-Cal	$12	114%
Medi-Cal	$12	114%
Ah Employee Health Plan - All Plans	$19	180%
Aetna	$93	881%
Blue Cross Blue Shield	$107 - $143	1013%

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 $45.
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 Adventist Health Ukiah Valley 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.