CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Palos Community Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $339
Cash Discount Price: $307
vs. Medicare Baseline: 32.10x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Palos Community Hospital is $339. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $307. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 32.10x the Medicare baseline. Located in 12251 South 80Th Avenue, Palos Heights, IL.

Cash / Self-Pay

$307

Average discount available for prompt cash payment at this facility.

Insurance Median

$339

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: $307 (2907%)

Insurance Median: $339 (3210%)

Cash: $307 (2907% of Medicare)

Ins. Median: $339 (3210% 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 3210% of the Medicare baseline (a markup of 3110%). 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	$70 - $438	663%
Aetna	$94 - $438	890%
Carelon Behavioral Health [159]	$219	2074%
Healthlink [125]	$219 - $438	2074%
Magellan Behavioral Hlth [136]	$263	2491%
Multiplan/Phcs [142]	$307 - $438	2907%
Compsych [112]	$328	3106%
First Health Plan [6034]	$328	3106%
Beechstreet [176]	$350	3314%
Cigna	$350 - $438	3314%
Health'S Finest Network [126]	$372	3523%
Galaxy Health Network [220]	$438	4148%
Global Excel [1712]	$438	4148%
Health Alliance [181]	$438	4148%
UnitedHealthcare	$438	4148%

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 $307.
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 Palos Community 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.