CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Atrium Health Navicent Rehabilitation Hopsital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $29
Cash Discount Price: $109
vs. Medicare Baseline: 2.75x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Atrium Health Navicent Rehabilitation Hopsital is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $109. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 2.75x the Medicare baseline. Located in 3351 Northside Dr, Macon, GA.

Cash / Self-Pay

$109

Average discount available for prompt cash payment at this facility.

Insurance Median

$29

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: $109 (1032%)

Insurance Median: $29 (275%)

Cash: $109 (1032% of Medicare)

Ins. Median: $29 (275% 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 275% of the Medicare baseline (a markup of 175%). 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
UnitedHealthcare	$6 - $11	57%
Aetna	$11 - $153	104%
Alliant	$11 - $13	104%
Blue Cross Blue Shield	$11 - $13	104%
Care Source	$11	104%
Clover	$11	104%
Eon Health	$11	104%
Georgia Health Advantage	$11	104%
Humana	$11 - $150	104%
Pruitt Health	$11	104%
Kaiser	$12 - $38	114%
Cigna	$14 - $29	133%
Securehealth	$26 - $76	246%
Ibg	$31 - $154	294%
Ambetter / Centene	$65 - $111	616%
Multiplan	$142 - $174	1345%
Novanet	$174	1648%
Three Rivers Provider Network	$185	1752%
Beechstreet	$203	1922%

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 $109.
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 Atrium Health Navicent Rehabilitation Hopsital 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.