CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Saint Mary's Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $19
  • Cash Discount Price: $47
  • vs. Medicare Baseline: 1.80x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Saint Mary's Hospital is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.80x the Medicare baseline. Located in 56 Franklin Street, Waterbury, CT.
Cash / Self-Pay
$47

Average discount available for prompt cash payment at this facility.

Insurance Median
$19

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: $47 (445%)
Insurance Median: $19 (180%)
Cash: $47 (445% of Medicare)
Ins. Median: $19 (180% 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.

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 $9 - $12 85%
Aetna $10 - $19 95%
Medicare (plans) $10 - $11 95%
UnitedHealthcare $10 - $86 95%
Cca Senior Care Options $11 104%
Cigna $11 - $69 104%
Geha $11 104%
Harvard Pilgrim Healthcare $11 104%
Bcn Domestic $12 114%
Blue Benefit Administrators of Massachusetts $12 114%
Blue Care Network $12 114%
Blue Distinction Transplant $12 114%
Blue Shield - Ca $12 114%
Blue Shield - Id (Regence) $12 114%
Blue Shield - Ny Highmark Northeastern $12 114%
Blue Shield - Ny Highmark Western $12 114%
Blue Shield - PA (Highmark) $12 114%
Blue Shield - Wa (Regence) $12 114%
Connecticare $12 114%
Health Choices $12 114%
Kaiser Domestic $12 114%
Pre-Employment $12 114%
Unicare $12 114%
Wc Domestic $12 114%
Wellpoint $12 114%
Centivo $13 123%
1199 National Benefit Fund $19 180%
Allied Benefit Systems $19 180%
Gravie Admin Services $19 180%
Hap $19 180%
Luminare Health $19 180%
Meritain $19 180%
Nippon Life Ins $19 180%
Webtpa $19 180%
Allegiance $21 199%
Health Partners $21 199%
Magnacare $21 199%
Claimdoc $22 208%
Connecticut Dept of Correction $22 208%
Diversified Administrators $22 208%
Innovative Health Plan II $22 208%
Carelon Behavioral Health $43 407%
Health New England $46 436%
Allied National Global Care $66 625%
Asrm - Reliance Standard Life Insurance $66 625%
Christian Care Ministry $66 625%
Dean Health $66 625%
Fallon Health $66 625%
Family Life Insurance Company $66 625%
Ghc Scw $66 625%
International Benefit Administrators $66 625%
Lifetime Benefit Solutions $66 625%
Manhattan Life $66 625%
Medi Share $66 625%
Multiplan $66 625%
Mvp $66 625%
PHCS $66 625%
Pai $66 625%
Pan-American Life $66 625%
Paramount HMO $66 625%
Trinity Health Share $66 625%
Prime Health Services $69 653%
Health Smart $73 691%
United Behavioral Health Eap $86 814%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 56 Franklin Street, Waterbury, CT 06706
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals