CMS Price Transparency Data
Blood test, comprehensive metabolic panel
Facility: Whittier Hospital Medical Center
Billing Code: 80053 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80053
- Insurance Median: $13
- Cash Discount Price: $90
- vs. Medicare Baseline: 1.23x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Whittier Hospital Medical Center is $13. 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 1.23x the Medicare baseline. Located in 9080 Colima Rd, Whittier, CA.
Cash / Self-Pay
$90
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: $90 (852%)
Insurance Median: $13 (123%)
Cash: $90 (852% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Veterans Administration | $7 | 66% |
| Ahmc Medi-Cal Reciprocity Agreement | $9 | 85% |
| Aids Healthcare Foundation | $9 - $10 | 85% |
| Allied Physicians | $9 - $16 | 85% |
| Alta Med Health Network | $9 - $10 | 85% |
| Altamed Health Services Corporation | $9 | 85% |
| Beverly Hospital | $9 - $12 | 85% |
| Brand New Day | $9 - $13 | 85% |
| Emanate Health | $9 - $13 | 85% |
| Health Net | $9 - $399 | 85% |
| Healthy Way La | $9 | 85% |
| Heritage Provider Network | $9 - $14 | 85% |
| Kaiser Foundation | $9 - $467 | 85% |
| La Care Healthy Families/Healthy Kids | $9 | 85% |
| Non Contracted Medi-Cal | $9 | 85% |
| Prospect Health Plan | $9 - $17 | 85% |
| Synermed | $9 - $11 | 85% |
| Aetna | $10 - $486 | 95% |
| Alignment Health Plan | $10 | 95% |
| Alta Los Angeles Hospitals Inc | $10 | 95% |
| Apa/Aco Inc | $10 | 95% |
| Avanti | $10 - $13 | 95% |
| Blue Cross Blue Shield | $10 - $334 | 95% |
| Caloptima | $10 - $13 | 95% |
| Central Health Plan | $10 | 95% |
| Easy Choice Health Plan | $10 | 95% |
| Humana | $10 | 95% |
| La Care Health Plan | $10 - $367 | 95% |
| Medicare (plans) | $10 - $11 | 95% |
| Pacificare Of California | $10 | 95% |
| Scan Health Plan | $10 | 95% |
| Blue Shield Of California | $11 - $334 | 104% |
| Care First Health Plan | $11 | 104% |
| Caremore | $11 | 104% |
| County Of Los Angeles Dept Of Health Services | $11 | 104% |
| Cov19 Hrsa Uninsured Testing And Treatment Fund | $11 | 104% |
| Hollywood Presbyterian Adv Med Mcal | $11 | 104% |
| Hollywood Presbyterian Medpoint Mcal | $11 | 104% |
| La Care Covered Direct | $11 | 104% |
| Medi Caid/ Medi Cal | $11 | 104% |
| Molina Healthcare Of California | $11 | 104% |
| Pacific Alliance Medical Center | $11 | 104% |
| Pacific Independent Physician Association | $11 - $200 | 104% |
| Private Pay | $11 | 104% |
| Self-Pay | $11 | 104% |
| Cigna | $12 | 114% |
| Fmc Los Angeles County | $12 - $500 | 114% |
| Interplan Health Group | $12 | 114% |
| San Miguel Health Plan | $12 | 114% |
| Tricare | $12 | 114% |
| Ahmc Health | $13 | 123% |
| Applecare Medical Group | $13 | 123% |
| Athens Administrators Ahmc Work Comp | $13 | 123% |
| Chinatown Service Center Pace | $13 | 123% |
| Knox-Keene Act | $13 | 123% |
| Misc 1 | $13 | 123% |
| Molina Medical Center | $13 - $260 | 123% |
| Monarch Healthplan | $13 | 123% |
| Multiplan Wc | $13 | 123% |
| UnitedHealthcare | $21 - $644 | 199% |
| Health Net Inc | $26 - $434 | 246% |
| Capnet | $27 | 256% |
| Healthnet | $32 - $463 | 303% |
| Physician Healthways | $67 | 634% |
| Physicians Healthways Medical Corporation | $167 | 1581% |
| Ahmc Reciprocity | $200 | 1894% |
| Ahmc Reciprocity Agreement Senior/Commercial | $200 | 1894% |
| Wear And Wood | $200 - $267 | 1894% |
| Edward Medical Group | $233 | 2206% |
| Central Health Plan Of California | $267 | 2528% |
| Allied Physicians Ipa | $300 | 2841% |
| Prospect Medical | $367 | 3475% |
| Care 1St Health Plan | $400 | 3788% |
| New Horizon Medical Group Inc | $400 | 3788% |
| Cost Containment | $434 | 4110% |
| Davita Healthcare Partners | $434 | 4110% |
| Universal Care | $434 - $467 | 4110% |
| Asi/Flex | $467 | 4422% |
| Us Comp Care | $467 | 4422% |
| Value Healthplan Of California | $467 | 4422% |
| Community Care Network | $500 | 4735% |
| Coventry Health Care | $500 | 4735% |
| Coventry Health Care National Network | $500 | 4735% |
| Interplan Corporation | $500 | 4735% |
| Managed Care Administrators | $500 | 4735% |
| Prohealth | $500 | 4735% |
| Multiplan | $567 | 5369% |
| Commercial Non Contract | $667 | 6316% |
| Medi-Cal Sub Acute | $667 | 6316% |
| One Legacy | $667 | 6316% |
| Great-West Healthcare Of California | $2,500 | 23674% |