CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Saint Francis Hospital-Evanston

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $11
  • Cash Discount Price: $10
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Saint Francis Hospital-Evanston is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.04x the Medicare baseline. Located in 355 Ridge Ave, Evanston, IL.
Cash / Self-Pay
$10

Average discount available for prompt cash payment at this facility.

Insurance Median
$11

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: $10 (95%)
Insurance Median: $11 (104%)
Cash: $10 (95% of Medicare)
Ins. Median: $11 (104% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Cigna $6 - $44 57%
Aetna $9 - $16 85%
Blue Cross Blue Shield $9 - $15 85%
Countycare $9 85%
Humana $9 - $12 85%
Medicaid / KanCare $9 85%
Meridian $10 - $11 95%
Molina $10 - $16 95%
Celtic (Wellcare) $11 104%
Clear Spring Health Of Illinois $11 104%
Devoted Health $11 104%
Essential Health Partners $11 - $12 104%
Illinois Physicians Alliance $11 104%
Longevity Health Plan Of Illinois $11 104%
Medicare (plans) $11 104%
Provider Partners Health Plan (Pphp) $11 104%
Ravenswood Physicians Associates Ipa $11 104%
Resurrection Physicians Provider Group Ipa $11 - $14 104%
Self-Pay $11 104%
Tricare $11 104%
UnitedHealthcare $11 - $13 104%
Zing Health Provider Network $11 104%
Access Community Health Network $13 123%
Imagine Health Network, Inc. $15 142%
Clifton Health Systems $16 152%
Ambetter / Centene $17 161%
Hfn Inc (Healthcare Finest Network) $179 1695%
Coventry $183 1733%
Workers Comp $183 1733%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 355 Ridge Ave, Evanston, IL 60202
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals