CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Adventist Health Twin Cities

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $143
Cash Discount Price: $160
vs. Medicare Baseline: 13.54x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Adventist Health Twin Cities is $143. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $160. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 13.54x the Medicare baseline. Located in 1100 Las Tablas Rd, Templeton, CA.

Cash / Self-Pay

$160

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: $160 (1515%)

Insurance Median: $143 (1354%)

Cash: $160 (1515% 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.

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	104%
Cencal Mcr Adv - All Other Plans	$11	104%
Tricare	$11	104%
UnitedHealthcare	$11 - $91	104%
Cfmg-Ca Forensic Med Grp Op/Profee Only-All Plans	$14	133%
Ah Employee Health Plan - All Plans	$19	180%
Hpn-Heritage Prov Ntwrk-All Plans	$91	862%
Blue Shield Epo/Ppo - All Other Plans	$130	1231%
Nbd-Ntwrks By Design Non-Exlus	$155	1468%
Ccah-Centrl Ca Allince Mcal-All Plans	$350	3314%
Blue Shield Epn	$824	7803%
Blue Shield Hmo/Pos	$948	8977%
Chn-Community Hlth Ntwrk-All Plans	$1,260	11932%
Nbd-Ntwrks By Design Exlus-All Other Plans	$1,322	12519%
Pacific Health Alliance-All Plans	$2,061	19517%
Medi-Cal	$2,290	21686%
Cencal Mcal	$2,611	24725%
Blue Shield Promise Mcal	$2,753	26070%
Coalinga-All Plans	$2,977	28191%

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 $160.
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 Adventist Health Twin Cities 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.