CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Boulder Community Health

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $109
  • Cash Discount Price: $111
  • vs. Medicare Baseline: 10.32x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Boulder Community Health is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $111. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 10.32x the Medicare baseline. Located in 4747 Arapahoe Avenue, Boulder, CO.
Cash / Self-Pay
$111

Average discount available for prompt cash payment at this facility.

Insurance Median
$109

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: $111 (1051%)
Insurance Median: $109 (1032%)
Cash: $111 (1051% of Medicare)
Ins. Median: $109 (1032% 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 1032% of the Medicare baseline (a markup of 932%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Blue Cross Blue Shield $4 - $188 38%
UnitedHealthcare $4 - $11 38%
Humana $7 - $11 66%
Aetna $8 - $274 76%
Health Spring $8 76%
Medicare (plans) $9 - $120 85%
Select Health Colorado Public Option $9 - $120 85%
Select Health Value Network $9 - $120 85%
Clear Spring $11 104%
Devoted Health $11 - $126 104%
Rocky Mountain Health Maintenance Organization $11 104%
Cigna $12 - $252 114%
Multiplan $17 - $220 161%
Phcs $17 - $220 161%
Kaiser Public Option $20 189%
Kaiser $25 237%
Kaiser Ppo $25 237%
Rocky Mountain Health Maintenance Organization Private Plan $90 - $220 852%
Integrated Health Plans Bch $96 - $236 909%
Casualty Management Network, Prime Health Services Behavioral Health $109 - $268 1032%
Mines And Associates $109 - $268 1032%
Three Rivers Provider Network $109 - $268 1032%
Zelis (Profee) $109 - $268 1032%
Casualty Management Network, Prime Health Services Community Medical Associates $115 - $284 1089%
National Preferred Provider Network $115 - $284 1089%
Rockport Healthcare Group Community Medical Associates $115 - $284 1089%
Usa $115 - $284 1089%
Rockport Healthcare Group Bch $119 - $293 1127%
Health Payors Organization $122 - $299 1155%
Health Management Network Bch Community Medical Associates $123 - $302 1165%
Health Management Network Community Medical Associates $123 - $302 1165%
National Provider Network $124 - $306 1174%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4747 Arapahoe Avenue, Boulder, CO 80304
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals