CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: San Dimas Community Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $11
Cash Discount Price: $10
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at San Dimas Community Hospital is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.04x the Medicare baseline. Located in 1350 W Covina Blvd, San Dimas, CA.

Cash / Self-Pay

$10

Average discount available for prompt cash payment at this facility.

Insurance Median

$11

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: $10 (95%)

Insurance Median: $11 (104%)

Cash: $10 (95% of Medicare)

Ins. Median: $11 (104% 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
Rios	$10	95%
Aids Healthcare Foundation	$11	104%
Blue Cross Blue Shield	$11 - $68	104%
Blue Shield Of Ca	$11 - $22	104%
Blue Shield Of Promise	$11	104%
Brand New Day	$11 - $16	104%
Central Health Plan	$11	104%
Choice Physicians Network	$11	104%
Citrus Valley Physicians Group	$11	104%
Elite Health Plan	$11	104%
Health Excel Inc	$11	104%
Health Net Of Ca	$11 - $15	104%
Heritage Provider Network Inc	$11 - $14	104%
Imperial Health Plan Inc	$11	104%
La Care Health Plan	$11	104%
Medicare (plans)	$11	104%
Molina Healthcare	$11	104%
Patient Choice Health Plan	$11	104%
Primecare Medical Network	$11 - $14	104%
Renal Payer Solutions	$11	104%
Traditional Medi-Cal	$11	104%
Tricare	$11	104%
UnitedHealthcare	$11 - $18	104%
Aetna	$13	123%
Ca Foundation For Medical Care	$14	133%
Worker Comp	$14	133%
Employer Direct Healthcare	$15	142%

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 $10.
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 San Dimas Community 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.