CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Good Samaritan Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $14
  • Cash Discount Price: $3,215
  • vs. Medicare Baseline: 1.33x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Good Samaritan Hospital is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,215. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.33x the Medicare baseline. Located in 2425 Samaritan Drive, San Jose, CA.
Cash / Self-Pay
$3,215

Average discount available for prompt cash payment at this facility.

Insurance Median
$14

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: $3,215 (30445%)
Insurance Median: $14 (133%)
Cash: $3,215 (30445% of Medicare)
Ins. Median: $14 (133% 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
Aetna $11 - $54 104%
Affinity Medical Group $11 104%
Alignment Health Plan $11 104%
Blue Cross Blue Shield $11 - $55 104%
Blue Shield $11 - $20 104%
Care1St Health Plan $11 104%
Central Health Plan $11 104%
Clever Care Of Golden State $11 104%
Easy Choice Health Plan $11 104%
Humana $11 - $2,251 104%
Managed Health Network $11 104%
On Lok Senior Health $11 104%
Palo Alto Medical $11 - $14 104%
Santa Clara Family Health Plan $11 - $611 104%
Scan Health Plan $11 104%
Triwest Healthcare Alliance $11 104%
United $11 - $820 104%
University Healthcare $11 104%
Vitality Health Plan $11 104%
Corvel Corporation $12 114%
Health Net $12 - $749 114%
Physicians Medical Group $12 114%
Affinity Medical Group Comm $14 133%
Canopy $19 180%
Bright Health $21 199%
Cigna $110 - $2,572 1042%
Medcare Partners $482 4564%
Nx Health Network $1,929 18267%
Sutter Select $1,929 18267%
Multiplan $2,090 - $2,572 19792%
First Health $2,444 - $3,215 23144%
Healthsmart $2,572 24356%
Intercontinental Corporation $2,572 24356%
Pha Pacific Health Alliance $2,572 24356%
Ppo Next $2,572 24356%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2425 Samaritan Drive, San Jose, CA 95124
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals