CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Montclair Hospital Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $11
Cash Discount Price: $10
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Montclair Hospital Medical Center is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.04x the Medicare baseline. Located in 5000 San Bernardino Road, Montclair, CA.

Cash / Self-Pay

$10

Average discount available for prompt cash payment at this facility.

Insurance Median

$11

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: $10 (95%)

Insurance Median: $11 (104%)

Cash: $10 (95% of Medicare)

Ins. Median: $11 (104% 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
Rios	$10	95%
Alignment	$11	104%
Blue Shield Of Promise	$11	104%
Brand New Day	$11 - $16	104%
Central Health Plan	$11	104%
Choice Physicians Network	$11	104%
Citrus Valley Physicians Group	$11	104%
Elite Health Plan	$11	104%
Emanate Health	$11 - $21	104%
Epic Health Plan	$11	104%
Health Net Of Ca	$11 - $15	104%
Imperial Health Plan Of Ca	$11	104%
Inland Empire Foundation For Medical Care	$11	104%
Inland Empire Healthplan	$11 - $15	104%
Medicare (plans)	$11	104%
Molina	$11	104%
Neighborhood	$11	104%
Renal Payor Solution	$11	104%
Traditional Medi-Cal	$11	104%
Tricare	$11	104%
Vantage Care	$11	104%
Coventry Workers Compensation	$13	123%
Health Net Federal Services Prison (Cdcr)	$13	123%
Worker Compensation	$14	133%
Blue Cross Blue Shield	$15	142%
Employer Direct Health Care	$15	142%

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 $10.
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 Montclair Hospital Medical Center 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.