CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Kapiolani Medical Center for Women & Children

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $55
Cash Discount Price: $67
vs. Medicare Baseline: 5.21x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Kapiolani Medical Center for Women & Children is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $67. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 5.21x the Medicare baseline. Located in 1319 Punahou Street, Honolulu, HI.

Cash / Self-Pay

$67

Average discount available for prompt cash payment at this facility.

Insurance Median

$55

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: $67 (634%)

Insurance Median: $55 (521%)

Cash: $67 (634% of Medicare)

Ins. Median: $55 (521% 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 521% of the Medicare baseline (a markup of 421%). 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
Alohacare	$10 - $12	95%
Hmsa	$10 - $23	95%
Kaiser	$10 - $100	95%
Mdx	$10 - $12	95%
Devoted	$11	104%
Ohana	$13 - $33	123%
Hcha	$21	199%
UnitedHealthcare	$22	208%
Pac Admin	$23	218%
Uha	$24 - $57	227%
Hwmg/Hmaa	$27	256%
Mimoh	$76 - $86	720%
Calvos	$82 - $86	777%
Multiplan	$87 - $97	824%
Verdegard	$87 - $91	824%
Mccp	$93 - $97	881%
Coventry	$98 - $103	928%

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 $67.
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 Kapiolani Medical Center for Women & Children 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.