Blood test, comprehensive metabolic panel
Facility: Greater El Monte Community Hospital
Billing Code: 80053 (CPT)
- CPT Billing Code: 80053
- Insurance Median: $184
- Cash Discount Price: $1,016
- vs. Medicare Baseline: 17.42x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 1742% of the Medicare baseline (a markup of 1642%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Care 1St Medi Cal Hmo Cap Exceptional Care | $2 - $129 | 19% |
| Care First Health Plan | $2 - $129 | 19% |
| Clinica Medica Familiar | $2 - $644 | 19% |
| Alta Med Health Services Med Grp | $4 - $322 | 38% |
| Bella Vista Medical Group Ipa | $4 - $579 | 38% |
| Employee Health Systems Medical Group | $4 - $257 | 38% |
| Global Care Medical Group Ipa | $4 - $579 | 38% |
| Ahmc Reciprocity Agreement | $5 - $386 | 47% |
| Ahmc Reciprocity Agreement Senior/Commercial | $5 - $386 | 47% |
| Allied Physicians Medical Group | $5 - $386 | 47% |
| Good Samaritan Medical Practice Assoc | $5 - $772 | 47% |
| Lincoln Hospital Medical Center | $5 - $386 | 47% |
| Blue Cross Blue Shield | $6 - $644 | 57% |
| Molina Healthcare Of California | $7 - $502 | 66% |
| Veterans Administration | $7 | 66% |
| Ahmc Healthcare Inc | $9 | 85% |
| Aids Health Foundation | $9 - $10 | 85% |
| Altamed Health Network | $9 - $10 | 85% |
| Avanti | $9 - $13 | 85% |
| Beverly Hospital | $9 - $12 | 85% |
| Blue Shield Of California | $9 - $644 | 85% |
| Brand New Day | $9 - $13 | 85% |
| California Thoroughbred Horesmans Foundation | $9 - $644 | 85% |
| Emanate Health | $9 - $13 | 85% |
| Health Net Foundation | $9 - $837 | 85% |
| Healthy Way La | $9 | 85% |
| La Care Health Plan | $9 - $708 | 85% |
| Other Non Contracted Medi-Cal Hmo | $9 | 85% |
| State Of California | $9 | 85% |
| Universal Care | $9 - $901 | 85% |
| Alignment Health Plan | $10 | 95% |
| Allied Physicians | $10 - $16 | 95% |
| Apa/Aco Inc | $10 | 95% |
| Cms | $10 | 95% |
| Easy Choice Health Plan | $10 | 95% |
| Health Net Inc | $10 - $911 | 95% |
| Other Non Contracted Senior Hmo | $10 | 95% |
| Pacific Alliance Medical Center Reciprocal Contract | $10 | 95% |
| Scan Health Plan | $10 | 95% |
| UnitedHealthcare | $10 - $1,105 | 95% |
| Associated Hispanic Physicians | $11 | 104% |
| Care 1St Health Plan | $11 - $772 | 104% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $11 | 104% |
| Hollywood Presbyterian Adv Med Mcal | $11 | 104% |
| Hollywood Presbyterian Medpoint Mcal | $11 | 104% |
| Inter Valley Health Plan | $11 | 104% |
| Intercomp | $11 | 104% |
| La Care Covered Direct | $11 | 104% |
| Molina Healthcare | $11 | 104% |
| Pacificare Of California | $11 - $1,115 | 104% |
| Self-Pay | $11 | 104% |
| Central Health Plan | $12 - $901 | 114% |
| Champus Foundation | $12 | 114% |
| Chinatown Service Center Pace | $12 | 114% |
| Cigna | $12 | 114% |
| Cost Containment Strategies | $12 - $837 | 114% |
| In Custody Police Dept | $12 - $837 | 114% |
| Interplan | $12 - $965 | 114% |
| Preferred Health Network | $12 | 114% |
| San Miguel Health Plan | $12 | 114% |
| Ahmc Health Self-Insurance Epo | $13 | 123% |
| Athens Administrators | $13 | 123% |
| Knox-Keene Act | $13 | 123% |
| Multiplan | $13 - $1,094 | 123% |
| Other Non Contracted Work Comp | $13 | 123% |
| Caloptima | $14 | 133% |
| Community Care Network | $14 - $1,030 | 133% |
| Health Payors Organization | $16 - $1,158 | 152% |
| Commercial Non Contract | $18 - $1,287 | 170% |
| Medi-Cal Sub Acute | $18 - $1,287 | 170% |
| Nuclear Medicine/Whmc | $18 - $1,287 | 170% |
| One Legacy | $18 - $1,287 | 170% |
| In Custody-Ca Highway Patrol | $20 | 189% |