CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: John Muir Medical Center - Concord Campus

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $143
  • Cash Discount Price: $731
  • vs. Medicare Baseline: 13.54x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at John Muir Medical Center - Concord Campus is $143. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $731. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 13.54x the Medicare baseline. Located in 2540 East St, Concord, CA.
Cash / Self-Pay
$731

Average discount available for prompt cash payment at this facility.

Insurance Median
$143

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: $731 (6922%)
Insurance Median: $143 (1354%)
Cash: $731 (6922% of Medicare)
Ins. Median: $143 (1354% 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 1354% of the Medicare baseline (a markup of 1254%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Contra Costa County Jail [1012104] $9 85%
Health Net-Network Mcare [1028127] $10 95%
Aetna $11 - $1,174 104%
Alignment Health [1177113] $11 104%
Blue Cross Blue Shield $11 - $1,056 104%
Blue Shield-Network Mcare [1006127] $11 104%
Care 1St Health Plan [1094113] $11 104%
Caremore [1171113] $11 104%
Covid19 Hrsa Uninsured Testing And Treatment Fund [1179012] $11 104%
Easy Choice Health Plan [1083113] $11 104%
Essence Healthcare [1049028] $11 104%
Essence Healthcare [1049128] $11 104%
Golden State-Network Mcare [1023127] $11 104%
Hospice Of East Bay [1085104] $11 104%
Humana $11 - $1,348 104%
Medicare (plans) $11 - $1,299 104%
Scan-Network Mcare [1043127] $11 104%
UnitedHealthcare $11 - $950 104%
Veterans Administration [1051113] $11 104%
Jmpn Canopy Hn [1640000011] $12 114%
Generic Commercial/Indemnity [1017001] $13 - $650 123%
Generic Hmo [1018103] $13 123%
Generic Ppo [1021104] $13 123%
Workers' Comp [1024005] $13 123%
Canopy Hn Hmo [1166103] $19 180%
Brms [1091104] $143 1354%
Delta Health Systems [1032104] $143 1354%
Empire Plan [1092104] $143 1354%
Healthcomp [1089104] $143 - $1,380 1354%
Carecentrix [1011001] $650 6155%
Aps Healthcare [1003103] $731 6922%
United Behavioral Health [1048103] $816 7727%
Cigna $824 - $1,163 7803%
Carelon Behavioral Health [1050104] $893 8456%
Fortified Provider Network [1063104] $893 8456%
Medigap [1036001] $893 8456%
Three Rivers Provider Network [1073104] $893 8456%
Health Net Hmo [1028103] $927 8778%
Health Net-Network [1028026] $927 8778%
Contra Costa Health Plan Hmo [1013103] $974 9223%
Blue Shield Hmo [1006103] $1,007 - $1,031 9536%
Blue Shield-Network [1006026] $1,031 9763%
Blue Shield Ppo [1006104] $1,080 - $1,195 10227%
Western Health Advantage Hmo [1053103] $1,137 - $1,299 10767%
Health Net Ppo [1028104] $1,179 11165%
Kaiser Hmo [1033103] $1,202 11383%
Federal Correction Institute [1062104] $1,299 12301%
First Health [1016104] $1,299 - $1,380 12301%
Healthsmart - Pka Interplan [1031104] $1,299 12301%
Networks By Design [1084104] $1,299 12301%
Pponext [1072104] $1,299 12301%
Sutter Preferred Health Plan [1044104] $1,299 12301%
Health Management Network [1066104] $1,380 13068%
Galaxy Health Network [1064104] $1,462 13845%
Integrated Health Plan [1075104] $1,462 13845%
Donor Network West [1008103] $4,000 - $12,000 37879%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2540 East St, Concord, CA 94520
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals