CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Southwest Healthcare Rancho Springs Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $14
Cash Discount Price: $90
vs. Medicare Baseline: 1.33x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Southwest Healthcare Rancho Springs Hospital is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.33x the Medicare baseline. Located in 25500 Medical Center Drive, Murrieta, CA.

Cash / Self-Pay

$90

Average discount available for prompt cash payment at this facility.

Insurance Median

$14

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: $90 (852%)

Insurance Median: $14 (133%)

Cash: $90 (852% of Medicare)

Ins. Median: $14 (133% 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
Cigna	$1 - $161	9%
Heritage	$1 - $171	9%
Palomar	$1 - $211	9%
Primecare	$1 - $179	9%
Rady_Children'S_Hospital	$2 - $314	19%
Multiplan	$3 - $403	28%
Sharp_Health_Plan	$3 - $403	28%
Health_Net	$8 - $153	76%
Kaiser	$8 - $133	76%
United_Healthcare	$11 - $13	104%
Iehp	$14	133%
Blue Cross Blue Shield	$15 - $133	142%
Aetna	$63	597%

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 $90.
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 Southwest Healthcare Rancho Springs 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.