CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Seneca District Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $166
Cash Discount Price: $140
vs. Medicare Baseline: 15.72x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Seneca District Hospital is $166. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $140. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 15.72x the Medicare baseline. Located in 130 Brentwood Drive, Chester, CA.

Cash / Self-Pay

$140

Average discount available for prompt cash payment at this facility.

Insurance Median

$166

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: $140 (1326%)

Insurance Median: $166 (1572%)

Cash: $140 (1326% of Medicare)

Ins. Median: $166 (1572% 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 1572% of the Medicare baseline (a markup of 1472%). 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
Amthem Bc Mcal	$12	114%
Medi-Cal	$12	114%
Partnership Hp-All Plans	$12	114%
Ambetter / Centene	$15	142%
UnitedHealthcare	$66 - $172	625%
Tricare	$122	1155%
Imperial Hp Ma-All Plans	$138	1307%
Blue Cross Blue Shield	$143 - $158	1354%
Blue Shield Ipf/Ca Exchange	$156	1477%
Beech Street Corp- All Plans	$166	1572%
Cigna	$166	1572%
Integrated Hp-All Plans	$166	1572%
Interplan Corp- All Plans	$166	1572%
Medincrease- All Plans	$166	1572%
Multiplan- All Plans	$166	1572%
Pacificare - All Plans	$166	1572%
Provider Ntwrk Of America-All Plans	$166	1572%
Alliance- All Plans	$170	1610%
Community Care Network - All Plans	$170	1610%
Coventry- All Plans	$172	1629%
Northern Nevada Health Network- All Plans	$172	1629%
Superior California Ppo - All Plans	$172	1629%
Blue Shield Of Ca- All Other Plans	$173	1638%
Healthnet - All Other Plans	$173	1638%
Three Rivers- All Plans	$173	1638%

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 $140.
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 Seneca District Hospital 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.