CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Memorial Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $146
Cash Discount Price: $243
vs. Medicare Baseline: 13.83x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Memorial Medical Center is $146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $243. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 13.83x the Medicare baseline. Located in 701 N First St, Springfield, IL.

Cash / Self-Pay

$243

Average discount available for prompt cash payment at this facility.

Insurance Median

$146

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: $243 (2301%)

Insurance Median: $146 (1383%)

Cash: $243 (2301% of Medicare)

Ins. Median: $146 (1383% 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 1383% of the Medicare baseline (a markup of 1283%). 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
Health Alliance	$5 - $158	47%
Veterans Administration	$7	66%
Medicaid / KanCare	$9	85%
Molina	$9	85%
Aetna	$10 - $185	95%
Blue Cross Blue Shield	$10 - $243	95%
Medicare (plans)	$10 - $243	95%
Tricare	$10	95%
UnitedHealthcare	$10 - $151	95%
Humana	$11 - $146	104%
Healthlink	$37 - $153	350%
Current Health Network Ppo	$109	1032%
Cigna	$128	1212%
Commercial Workers Compensation	$129	1222%
Phcs/Multiplan	$131 - $146	1241%
Illinois Workers Compensation	$136	1288%
6 Degrees Health	$146	1383%
Hopetrust	$146	1383%
Hst	$146	1383%
Magellan	$146	1383%
Consociate	$158	1496%
Hfn	$158	1496%
Preferred Plan	$182	1723%
Soi Mcfarland	$182	1723%
Soi Rushville	$182	1723%
Corvel	$194	1837%
Methodist First Choice	$194	1837%
Mutual Medical Plans	$207	1960%
Liability	$243	2301%

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 $243.
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 Memorial 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.