CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Nell J Redfield Memorial Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $63
Cash Discount Price: $105
vs. Medicare Baseline: 5.97x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Nell J Redfield Memorial Hospital is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $105. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 5.97x the Medicare baseline. Located in 150 North 200 West, Malad City, ID.

Cash / Self-Pay

$105

Average discount available for prompt cash payment at this facility.

Insurance Median

$63

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: $105 (994%)

Insurance Median: $63 (597%)

Cash: $105 (994% of Medicare)

Ins. Median: $63 (597% 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 597% of the Medicare baseline (a markup of 497%). 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
Regence Bs Comm - All Other Plans	$13	123%
UnitedHealthcare	$13 - $105	123%
Bc Comm - All Other Plans	$57	540%
Bc Mcr Adv	$62	587%
Choicecare Mcr Adv	$62	587%
Regence Bs Mcr	$62	587%
Aetna	$63 - $101	597%
Pacificsource Mcr Adv - All Plans	$63	597%
University Of Ut - All Plans	$98	928%
Choicecare Ppo - All Other Plans	$105	994%
Town & Country - All Plans	$105	994%
Brightpath Select Hlth - All Plans	$111	1051%

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 $105.
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 Nell J Redfield Memorial Hospital 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.