CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Sterling Regional Medcenter

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $101
Cash Discount Price: $45
vs. Medicare Baseline: 9.56x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Sterling Regional Medcenter is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 9.56x the Medicare baseline. Located in 615 Fairhurst St, Sterling, CO.

Cash / Self-Pay

$45

Average discount available for prompt cash payment at this facility.

Insurance Median

$101

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: $45 (426%)

Insurance Median: $101 (956%)

Cash: $45 (426% of Medicare)

Ins. Median: $101 (956% 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 956% of the Medicare baseline (a markup of 856%). 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
Clear Spring Health	$11	104%
Humana	$11	104%
Longevity	$11	104%
UnitedHealthcare	$11 - $130	104%
Devoted Health Services	$12	114%
Pinnacol Assurance Workers Comp	$17 - $67	161%
Aetna	$38 - $127	360%
Banner Health	$42	398%
Blue Cross Blue Shield	$42 - $104	398%
Healthspring Life & Health Insurance Company, Inc.	$42	398%
Medica	$42 - $114	398%
Medicare (plans)	$42	398%
Assist Health Group	$51	483%
Denver Health Medical Plan	$83	786%
Apostrophe, Inc.	$123	1165%
First Choice Health Network	$123	1165%
First Choice Of The Midwest	$130	1231%
Hue Health, Inc	$130	1231%
Rocky Mountain Health Plans	$130	1231%
Multiplan	$133	1259%

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 $45.
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 Sterling Regional Medcenter 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.