CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Rush University Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $36
Cash Discount Price: $123
vs. Medicare Baseline: 3.41x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Rush University Medical Center is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $123. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 3.41x the Medicare baseline. Located in 1653 West Congress Parkway, Chicago, IL.

Cash / Self-Pay

$123

Average discount available for prompt cash payment at this facility.

Insurance Median

$36

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: $123 (1165%)

Insurance Median: $36 (341%)

Cash: $123 (1165% of Medicare)

Ins. Median: $36 (341% 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 341% of the Medicare baseline (a markup of 241%). 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 - $246	85%
County Care Mcaid - All Plans	$9	85%
Meridian Mcaid - All Other Plans	$9	85%
Molina Mcaid	$10	95%
Aetna	$11 - $246	104%
Meridian Dnsp	$11	104%
Molina Fide-Snp	$11	104%
Ambetter / Centene	$14	133%
Molina Exch - All Other Plans	$14	133%
Cigna	$26 - $246	246%
UnitedHealthcare	$34 - $332	322%
Devoted Mcr Adv - All Plans	$246	2330%
Humana	$246	2330%
Wellcare Mcr Adv - All Plans	$246	2330%
Zing Hlth Mcr Adv - All Plans	$261	2472%

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 $123.
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 Rush University 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.