CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Adventist Health Mendocino Coast

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $30
Cash Discount Price: $98
vs. Medicare Baseline: 2.84x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Adventist Health Mendocino Coast is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $98. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 2.84x the Medicare baseline. Located in 700 River Drive, Fort Bragg, CA.

Cash / Self-Pay

$98

Average discount available for prompt cash payment at this facility.

Insurance Median

$30

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: $98 (928%)

Insurance Median: $30 (284%)

Cash: $98 (928% of Medicare)

Ins. Median: $30 (284% 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 284% of the Medicare baseline (a markup of 184%). 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 - $231	9%
Blue Shield Epn	$5 - $108	47%
Tricare	$6 - $140	57%
Ah Employee Health Plan - All Plans	$7 - $148	66%
Great West Hmo/Pos/Epo/Oa	$8 - $185	76%
Healthnet - All Plans	$8 - $186	76%
Great West Ppo - All Other Plans	$9 - $200	85%
Multiplan - All Plans	$9 - $200	85%
Blue Shield - All Other Plans	$10 - $219	95%
Cigna	$10 - $222	95%
Ahcc - All Plans	$11 - $256	104%
Beech Street - All Plans	$11 - $256	104%
Medi-Cal	$12	114%
Partnership Hp Mcal-All Plans	$13 - $36	123%
Blue Cross Blue Shield	$87 - $96	824%

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 $98.
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 Mendocino Coast 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.