CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Adventist Health Tehachapi Valley

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $38
Cash Discount Price: $37
vs. Medicare Baseline: 3.60x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Adventist Health Tehachapi Valley is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 3.60x the Medicare baseline. Located in 1100 Magellan, Tehachapi, CA.

Cash / Self-Pay

$37

Average discount available for prompt cash payment at this facility.

Insurance Median

$38

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: $37 (350%)

Insurance Median: $38 (360%)

Cash: $37 (350% of Medicare)

Ins. Median: $38 (360% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 360% of the Medicare baseline (a markup of 260%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
UnitedHealthcare	$1 - $200	9%
Healthnet Mcare	$2 - $78	19%
Medicare (plans)	$2 - $78	19%
Tricare	$2 - $78	19%
Universal Ipa Mcr Adv Op/Profee Only-All Other Pla	$2 - $78	19%
Network Providers- All Plans	$3 - $99	28%
Kaiser Ip/Op Only- All Other Plans	$4 - $133	38%
Blue Shield Epn- All Other Plans	$5 - $173	47%
Centivo - All Plans	$5 - $174	47%
Western Grwrs/Pinnacle - All Plans	$5 - $171	47%
Blue Shield Non-Epn	$6 - $204	57%
Klhp-Kern Legacy Epo -All Other Plans	$6 - $204	57%
Ah Employee Health Plan - All Plans	$7 - $216	66%
Blue Cross Blue Shield	$7 - $235	66%
Cigna	$10 - $319	95%
Healthnet- All Other Plans	$10 - $314	95%
Coventry- All Plans	$11 - $367	104%
Bc Mcal	$12	114%
Kaiser Medi-Cal Ip/Op Only	$12	114%
Medi-Cal	$12	114%
Universal Ipa Mcal Op/Profee Only	$12	114%
Healthnet Medi-Cal	$13 - $15	123%
Khs-Kern Hlth Systm Mcal	$13 - $16	123%
Oscar Health Plan- All Plans	$17	161%
Aetna	$62	587%

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 $37.
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 Adventist Health Tehachapi Valley 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.