CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Scripps Green Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $63
Cash Discount Price: $98
vs. Medicare Baseline: 5.97x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Scripps Green Hospital is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $98. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 5.97x the Medicare baseline. Located in 10666 North Torrey Pines Road, La Jolla, CA.

Cash / Self-Pay

$98

Average discount available for prompt cash payment at this facility.

Insurance Median

$63

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: $98 (928%)

Insurance Median: $63 (597%)

Cash: $98 (928% of Medicare)

Ins. Median: $63 (597% 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 597% of the Medicare baseline (a markup of 497%). 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
Aetna	$11 - $198	104%
Alignment Health Plan [443]	$11	104%
Astiva Mcr Adv [464]	$11	104%
Bc Mcr Adv [830]	$11	104%
Blue Cross Blue Shield	$11 - $103	104%
Bs Mcr Adv [829]	$11	104%
Central Health Mcr Adv [441]	$11	104%
Cigna	$11 - $136	104%
Clever Care Mcr Adv [465]	$11	104%
D-Snp Mcr Adv [889]	$11	104%
Dsnp/Csnp - Generic [458]	$11	104%
Family Health Centers Pace Mcr Adv Hmo [556]	$11	104%
Family Health Centers Pace Medi-Cal [555]	$11	104%
Gary And Mary West Pace Medi-Cal Hmo [557]	$11	104%
Gpmg/Altura - Mcr Adv [888]	$11	104%
Hn Mcr Adv [832]	$11	104%
Humana	$11	104%
Integrated Health Partners - Mcr Adv [895]	$11	104%
Kaiser Northern Ca Region Mcr Adv [386]	$11	104%
La Care Mcr Adv Hmo [612]	$11	104%
Medicare (plans)	$11	104%
Mpmg Mcr Adv [836]	$11	104%
Mpmg [800]	$11	104%
Ocn Mcr Adv [890]	$11	104%
San Diego Pace Medi-Cal [553]	$11	104%
Scan Mcr Adv [835]	$11	104%
Scan [500]	$11	104%
Scan [818]	$11	104%
Sharp Comm Med Grp Mcr Adv [840]	$11	104%
Sharp Health Plan Mcr Adv [531]	$11	104%
Sharp Health Plan Mcr Adv [897]	$11	104%
Sharp Rees Stealy Med Grp Mcr Adv [841]	$11	104%
St Paul'S Pace Medi-Cal [551]	$11	104%
Ucsd Mcr Adv [873]	$11	104%
Uh Mcr Adv [831]	$11	104%
Uh Palomar Health Mcr Adv [885]	$11	104%
UnitedHealthcare	$11 - $137	104%
Health Net [340]	$17 - $132	161%
Prime Healthcare [614]	$18	170%
Prospect Med Group [893]	$18	170%
Radys Cpmg [803]	$31	294%
Mc Alignment [917]	$63	597%
Mc Blue Shield Promise Health Plan [914]	$63	597%
Mc Blue Shield [902]	$63	597%
Mc Health Net [904]	$63	597%
Mc Scan [905]	$63	597%
Mc United [906]	$63	597%
Bc [814]	$87	824%
Imperial County Phys Med Group [855]	$87 - $134	824%
Integrated Health Partners [894]	$87	824%
Perlman Med Group [899]	$87	824%
Sharp Comm Med Grp [812]	$87 - $178	824%
Sharp Rees Stealy Med Grp [811]	$87 - $178	824%
Ucsd [807]	$87 - $178	824%
Centivo [581]	$90	852%
Blue Shield [230]	$129 - $140	1222%
Hn [815]	$132	1250%
Bs [816]	$134 - $139	1269%
Uh [819]	$137	1297%
Rady Children'S Hospital [825]	$161	1525%
Palomar Health [892]	$178	1686%
Veba Med Grp [813]	$178	1686%
Kaiser Northern Ca Region Hmo/Ppo [384]	$213	2017%
Kaiser [380]	$213	2017%
Kaiser [383]	$213	2017%
Multi Plan Network [470]	$278	2633%
First Health Network [330]	$294	2784%
Pnoa [615]	$294	2784%
Choice Care Network [270]	$314	2973%
Healthsmart [350]	$314	2973%

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 $98.
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 Scripps Green Hospital 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.