CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Community Memorial Hospital - Ventura

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $15
Cash Discount Price: $57
vs. Medicare Baseline: 1.42x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Community Memorial Hospital - Ventura is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $57. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.42x the Medicare baseline. Located in 147 North Brent Street, Ventura, CA.

Cash / Self-Pay

$57

Average discount available for prompt cash payment at this facility.

Insurance Median

$15

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: $57 (540%)

Insurance Median: $15 (142%)

Cash: $57 (540% of Medicare)

Ins. Median: $15 (142% 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.

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
Seaview	$8	76%
Alignment Health Plan	$11	104%
Blue Cross Blue Shield	$11 - $14	104%
California Workers Compensation	$11	104%
Humana	$11	104%
Medicare (plans)	$11	104%
Non Contracted	$11	104%
Scan Health Plan	$11	104%
Tricare	$11	104%
UnitedHealthcare	$11 - $18	104%
Wellcare Of California	$11	104%
Medi-Cal	$13	123%
Cigna	$14	133%
Aetna	$15 - $72	142%
Medicaid / KanCare	$19 - $33	180%
Valley Care	$19 - $24	180%
Gold Coast Health Plan	$20 - $33	189%
Ventura County Health Care Plan	$24	227%
Kaiser Commercial	$38	360%
Blue Shield Epn	$42	398%
Health Net Commercial	$44	417%
Blue Shield Commercial	$47	445%
Multiplan	$57	540%

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 $57.
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 Community Memorial Hospital - Ventura 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.