CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Lost Rivers Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $74
Cash Discount Price: $94
vs. Medicare Baseline: 7.01x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Lost Rivers Medical Center is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $94. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 7.01x the Medicare baseline. Located in 551 Highland Drive, Arco, ID.

Cash / Self-Pay

$94

Average discount available for prompt cash payment at this facility.

Insurance Median

$74

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: $94 (890%)

Insurance Median: $74 (701%)

Cash: $94 (890% of Medicare)

Ins. Median: $74 (701% 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 701% of the Medicare baseline (a markup of 601%). 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
Humana	$12 - $74	114%
Regence Blue Shield-All Other Plans	$12	114%
Provider Network Of America-All Plans	$19	180%
Select Health Brightpath-All Other Plans	$66	625%
Tricare	$66	625%
Ihcn Brightpath-All Other Plans	$70	663%
Va Pccc-All Plans	$72	682%
Blue Cross Blue Shield	$74 - $117	701%
Ihcn Brightpath Mcr Adv	$74	701%
Molina Mcr Adv-All Plans	$74	701%
Pacificsource Mcr Adv	$74	701%
Regence/Brightpth Slhp Mcr	$74	701%
Select Health Mcr Adv	$74	701%
Prime Hlth Mcr Adv	$77	729%
Aetna	$80 - $110	758%
Cigna	$109	1032%
First Choice-All Plans	$109	1032%
Pacificsource Navigator-All Other Plans	$111	1051%
UnitedHealthcare	$111	1051%
Altius Health Plan-All Plans	$113	1070%

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 $94.
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 Lost Rivers 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.