CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: West Valley Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $112
Cash Discount Price: $302
vs. Medicare Baseline: 10.61x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at West Valley Medical Center is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $302. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 10.61x the Medicare baseline. Located in 1717 Arlington Street, Caldwell, ID.

Cash / Self-Pay

$302

Average discount available for prompt cash payment at this facility.

Insurance Median

$112

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: $302 (2860%)

Insurance Median: $112 (1061%)

Cash: $302 (2860% of Medicare)

Ins. Median: $112 (1061% 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 1061% of the Medicare baseline (a markup of 961%). 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
Blue Cross Blue Shield	$9 - $1,109	85%
Molina	$9 - $11	85%
Humana	$11 - $253	104%
Regence Blue Shield	$11	104%
St Luke'S Health Partners	$11	104%
United	$11 - $180	104%
Veteran'S Administration	$11	104%
Regence	$22	208%
Select Health Idaho (Eirmc Only)	$96	909%
Corizon Health	$112	1061%
True Blue	$119	1127%
Cigna	$169	1600%
Pacificsource Health	$180	1705%
Moda	$188	1780%
Aetna	$239	2263%
Four Rivers Hospice	$241	2282%
Multiplan	$241	2282%
Geha Ppo Usa	$256	2424%
Coventry First Health	$271	2566%
St Alphonsus Health	$271	2566%

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 $302.
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 West Valley Medical Center 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.