CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Children's Healthcare of Atlanta at Scottish Rite

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $393
Cash Discount Price: $574
vs. Medicare Baseline: 37.22x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Children's Healthcare of Atlanta at Scottish Rite is $393. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $574. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 37.22x the Medicare baseline. Located in 1001 Johnson Ferry Road, Atlanta, GA.

Cash / Self-Pay

$574

Average discount available for prompt cash payment at this facility.

Insurance Median

$393

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: $574 (5436%)

Insurance Median: $393 (3722%)

Cash: $574 (5436% of Medicare)

Ins. Median: $393 (3722% 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 3722% of the Medicare baseline (a markup of 3622%). 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
Caresource [61]	$15	142%
Peachstate [43]	$15	142%
Amerigroup [102]	$17	161%
Cigna	$379	3589%
Blue Cross Blue Shield	$381 - $560	3608%
United [5]	$381	3608%
Ambetter / Centene	$384	3636%
Oscar [228]	$385	3646%
Aetna	$386	3655%
Caresource Marketplace Bronze/Silver/Gold [60]	$390	3693%
Kaiser [6]	$391	3703%
Sidecar Health [236]	$396	3750%
Direct Employer Agreements [72]	$402 - $488	3807%
Coventry [9]	$403	3816%
Northeast Georgia Heatlh System [808]	$430	4072%
Veracity Benefits [809]	$430	4072%
First Health [74]	$431	4081%
Phcs [93]	$488	4621%
Secure Health [340]	$488	4621%
Beech Street [71]	$517	4896%
Multiplan [92]	$563	5331%
Novanet [41]	$574	5436%

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 $574.
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 Children's Healthcare of Atlanta at Scottish Rite 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.