CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: UCSF Health St. Mary's Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $13
Cash Discount Price: $971
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at UCSF Health St. Mary's Hospital is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $971. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.23x the Medicare baseline. Located in 450 Stanyan St, San Francisco, CA.

Cash / Self-Pay

$971

Average discount available for prompt cash payment at this facility.

Insurance Median

$13

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: $971 (9195%)

Insurance Median: $13 (123%)

Cash: $971 (9195% of Medicare)

Ins. Median: $13 (123% 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
Aetna	$11 - $59	104%
Blue Cross Blue Shield	$11 - $270	104%
Blue Shield Ca	$11 - $363	104%
Brown Toland	$11	104%
Chinese Community	$11 - $291	104%
Connected Care	$11	104%
Health Net	$11 - $19	104%
Health Plan San Mateo	$11 - $13	104%
Humana	$11	104%
Kaiser	$11 - $340	104%
Mhn	$11	104%
United	$11 - $13	104%
California Health & Wellness	$13	123%
Partnership Health Plan	$13	123%
Sfhp	$13	123%
Kentfield	$31	294%
Oscar	$35	331%
Cigna	$46 - $49	436%
Magellan	$269 - $896	2547%
Healthsmart	$314 - $1,046	2973%
Multiplan	$372 - $1,240	3523%
Us Behavioral Health	$448	4242%

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 $971.
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 UCSF Health St. Mary's 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.