CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: North Shore Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $16
  • Cash Discount Price: $2,420
  • vs. Medicare Baseline: 1.52x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at North Shore Medical Center is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,420. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.52x the Medicare baseline. Located in 1100 Nw 95Th St, Miami, FL.
Cash / Self-Pay
$2,420

Average discount available for prompt cash payment at this facility.

Insurance Median
$16

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: $2,420 (22917%)
Insurance Median: $16 (152%)
Cash: $2,420 (22917% of Medicare)
Ins. Median: $16 (152% 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
Cigna $5 - $1,210 47%
Humana $5 - $966 47%
Medicaid / KanCare $5 - $2,420 47%
UnitedHealthcare $5 - $10 47%
Veterans Administration Mill Bill $7 66%
Avmed Broad Network $9 85%
Medicare (plans) $9 - $2,420 85%
Aetna $10 - $1,742 95%
Devoted Health $10 95%
Leon Health Inc $10 95%
Employer Direct Healthcare $11 - $13 104%
Healthsun Health Plans $11 104%
Hospice Other $11 104%
Longevity Health Plan $11 104%
Tricare $11 104%
Veterans Administration Vaccn $11 104%
Florida Pace Centers $12 114%
Bright Health Management Commercial $13 123%
Centurion Prison $13 123%
Imagine Health $13 123%
Oscar Health Plan Hix $13 123%
Self Pay/Uninsured $13 123%
Avmed Exchange $18 170%
Ambetter / Centene $20 189%
Molina Marketplace Program Exchange $20 189%
Auto Insurance $21 199%
Dimension Health Wc $21 199%
Workers Compensation $21 199%
Avmed Select Network $22 208%
Amerihealth Caritas Next Exchange $23 218%
Bc/Bs Myblue Hmo Hix $299 2831%
Bc/Bs Of Fl Network Blue $322 3049%
Bc/Bs Of Fl Ppo $322 3049%
Bc/Bs Of Fl Simplyblue $322 3049%
Bc/Bs Of Fl Blue Select Exchange Non Par $347 3286%
Bc/Bs Of Fl Health Options Hmo $347 3286%
Bc/Bs Of Fl Phs $1,254 11875%
Magellan Behavioral Health $1,452 13750%
Dimensions International $1,573 14896%
First Health $1,645 15578%
Dimension Health Ppo $1,815 17188%
Beacon Health Strategies Commercial $2,420 22917%
Commercial Non-Contracted $2,420 22917%
Self Pay - Mcd Pending 100 Percent $2,420 22917%
Single Case Agreement $2,420 22917%
United Behavioral Health Psych $2,420 22917%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 Nw 95Th St, Miami, FL 33150
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals