CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Morton Plant North Bay Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $27
Cash Discount Price: $23
vs. Medicare Baseline: 2.56x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Morton Plant North Bay Hospital is $27. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 2.56x the Medicare baseline. Located in 6600 Madison Street, New Port Richey, FL.

Cash / Self-Pay

$23

Average discount available for prompt cash payment at this facility.

Insurance Median

$27

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: $23 (218%)

Insurance Median: $27 (256%)

Cash: $23 (218% of Medicare)

Ins. Median: $27 (256% 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 256% of the Medicare baseline (a markup of 156%). 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
Aetna	$5 - $490	47%
Clear Health Alliance	$5	47%
Florida Community Care	$5	47%
Freedom Health	$5	47%
Humana	$5 - $13	47%
Molina Healthcare	$5	47%
Simply Healthcare	$5 - $108	47%
Sunshine Health	$5	47%
UnitedHealthcare	$5 - $541	47%
Freedom	$6 - $120	57%
Molina	$6 - $355	57%
Optimum	$6 - $120	57%
Careplus	$7 - $137	66%
Blue Cross Blue Shield	$9 - $318	85%
Ultimate Health Plan	$9 - $180	85%
Avmed	$10 - $294	95%
Baycareplus	$11	104%
Cigna	$12 - $523	114%
Solis Health	$12	114%
Wellcare	$15	142%
Evolutions	$16 - $559	152%
Ambetter / Centene	$24 - $601	227%
First Health	$26 - $511	246%
Multiplan	$28 - $541	265%
United Behavioral Health	$31 - $601	294%

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 $23.
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 Morton Plant North Bay 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.