CMS Price Transparency Data
Blood test, comprehensive metabolic panel
Facility: Coastal Communities Hospital
Billing Code: 80053 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80053
- Insurance Median: $13
- Cash Discount Price: $58
- vs. Medicare Baseline: 1.23x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Coastal Communities Hospital is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $58. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.23x the Medicare baseline. Located in 2701 S Bristol St, Santa Ana, CA.
Cash / Self-Pay
$58
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: $58 (549%)
Insurance Median: $13 (123%)
Cash: $58 (549% 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
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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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 |
|---|---|---|
| Monarch | $9 - $11 | 85% |
| Altamed Health Services | $10 - $15 | 95% |
| Altamed Mcal Hmo (Ancillary) | $11 | 104% |
| Blue Shield | $11 - $40 | 104% |
| Caloptima | $11 - $15 | 104% |
| Central Health Plan Of California | $11 | 104% |
| Champion Health Plan | $11 | 104% |
| Champus | $11 | 104% |
| Choice Physicians Network | $11 | 104% |
| Citizens Choice Health Plan | $11 | 104% |
| Clever Care Health Plan | $11 | 104% |
| Coventry Auto Network | $11 | 104% |
| Easy Choice Health Plan | $11 | 104% |
| For Your Benefit | $11 | 104% |
| Health Net | $11 - $42 | 104% |
| Healthcare Partners | $11 | 104% |
| Healthcare Partners Sr Hmo | $11 | 104% |
| Heritage | $11 | 104% |
| Hollywood Presbyterian | $11 | 104% |
| Humana | $11 | 104% |
| Imperial Health Plan Of Ca | $11 | 104% |
| Innovative Integrated Health | $11 | 104% |
| Kaiser | $11 - $36 | 104% |
| Kpc Healthcare Inc | $11 - $15 | 104% |
| Medcare Partners | $11 | 104% |
| Medi-Cal Hmo/Non Contract | $11 | 104% |
| Medicaid / KanCare | $11 | 104% |
| Onecare | $11 | 104% |
| Onecare Connect | $11 | 104% |
| Other Senior Non Contract | $11 | 104% |
| Prime Health Srvs/Wc | $11 | 104% |
| Prospect Health Plan | $11 - $16 | 104% |
| Scan Health Plan | $11 | 104% |
| Self Pay Ab774/Cbo Use Only | $11 | 104% |
| UnitedHealthcare | $11 | 104% |
| Us Dept Of Labor | $11 | 104% |
| Us Federal Marshall/Department Of Immigration | $11 | 104% |
| Velocity Provider Network Sr | $11 | 104% |
| Verda Health Plan Sr | $11 | 104% |
| Veterans Administration | $11 | 104% |
| Victim Of Violent Crime | $11 | 104% |
| Victoria Hospice | $11 | 104% |
| Brand New Day | $12 | 114% |
| Coventry Wc | $12 | 114% |
| Interplan | $12 - $44 | 114% |
| Monarch Health Plan | $12 | 114% |
| Multiplan | $12 - $41 | 114% |
| Prime Health Srvs | $12 - $46 | 114% |
| Three Rivers | $12 | 114% |
| County Of Orange/Custody/Advanced Medmgt | $13 | 123% |
| Velocity National Provider Network Wc | $13 | 123% |
| Veterans Evaluation Services | $13 | 123% |
| Workers Comp State Of California | $13 | 123% |
| Choc Health Alliance | $15 | 142% |
| County Of Orange | $15 | 142% |
| Family Choice | $15 | 142% |
| Heritage Provider Network | $15 - $35 | 142% |
| Staywell/Island Home Ins | $15 | 142% |
| Ihhi Reciprocity | $17 | 161% |
| Three Rivers Network | $18 | 170% |
| Velocity National Provider Network Ppo | $18 | 170% |
| Cigna | $21 - $38 | 199% |
| First Health | $30 | 284% |
| Aetna | $35 | 331% |
| Magellan | $35 | 331% |
| Networks By Design | $41 | 388% |
| Networks By Design Wc | $41 | 388% |
| Healthsmart | $44 | 417% |
| Prime Health | $44 | 417% |
| Pnoa-Provider Network Of America | $46 | 436% |
| Prime Health Srvs/Network | $49 | 464% |
| Lucet Behavioral Health Sr | $58 | 549% |
| Managed Health Network | $58 | 549% |
| Other Insurance Loa | $58 | 549% |
| Other Non Contracted Plans | $58 | 549% |
| Private Pay | $58 | 549% |
| Us Behavioral Health Plan | $58 | 549% |
| Vitas Hospice | $58 | 549% |