CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Coral Gables Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $13
  • Cash Discount Price: $974
  • vs. Medicare Baseline: 1.23x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Coral Gables Hospital is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $974. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.23x the Medicare baseline. Located in 3100 Douglas Rd, Coral Gables, FL.
Cash / Self-Pay
$974

Average discount available for prompt cash payment at this facility.

Insurance Median
$13

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: $974 (9223%)
Insurance Median: $13 (123%)
Cash: $974 (9223% of Medicare)
Ins. Median: $13 (123% 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 - $286 47%
Humana $5 - $356 47%
Medicaid / KanCare $5 47%
UnitedHealthcare $5 - $10 47%
Veterans Administration Mill Bill $7 66%
Avmed Broad Network $9 85%
Medicare (plans) $9 - $23 85%
Aetna $10 - $731 95%
Devoted Health $10 95%
Leon Health Inc $10 95%
Catholic Hospice $11 104%
Employer Direct Healthcare $11 - $13 104%
Hcr Manor Care Services Of Fl Ii Dba Heartland Hospice Services $11 104%
Healthsun Health Plans $11 104%
Hospice Other $11 104%
Longevity Health Plan $11 104%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $11 104%
Opus Care Of South Florida $11 104%
Seasons Hospice And Palliative Care Of Southern Florida Inc $11 104%
Tricare $11 104%
Veterans Administration Vaccn $11 104%
Vitas Healthcare Corporation/Hospice Ppo $11 104%
Florida Pace Centers $12 114%
Bright Health Management Commercial $13 123%
Imagine Health $13 123%
Oscar Health Plan Hix $13 123%
Self Pay/Uninsured $13 123%
Naphcare Inc $14 133%
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 $120 1136%
Bc/Bs Of Fl Network Blue $130 1231%
Bc/Bs Of Fl Ppo $130 1231%
Bc/Bs Of Fl Simplyblue $130 1231%
Bc/Bs Of Fl Blue Select Exchange Non Par $140 1326%
Bc/Bs Of Fl Health Options Hmo $149 1411%
Bc/Bs Of Fl Miami Dade Blue Select $149 1411%
Bc/Bs Of Fl Phs $523 4953%
Dimension International $633 5994%
First Health $692 6553%
Dimension Health Ppo $731 6922%
Commercial Non-Contracted $974 9223%
Self Pay - Mcd Pending 100 Percent $974 9223%
Single Case Agreement $974 9223%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3100 Douglas Rd, Coral Gables, FL 33134
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals