CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Jacksonville Memorial Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $219
Cash Discount Price: $380
vs. Medicare Baseline: 20.74x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Jacksonville Memorial Hospital is $219. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $380. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 20.74x the Medicare baseline. Located in 1600 W Walnut St, Jacksonville, IL.

Cash / Self-Pay

$380

Average discount available for prompt cash payment at this facility.

Insurance Median

$219

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: $380 (3598%)

Insurance Median: $219 (2074%)

Cash: $380 (3598% of Medicare)

Ins. Median: $219 (2074% 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 2074% of the Medicare baseline (a markup of 1974%). 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	$10 - $380	95%
Coventry	$10 - $60	95%
Health Alliance	$10 - $258	95%
Humana	$10 - $324	95%
Medicare (plans)	$10 - $60	95%
Tricare	$10 - $69	95%
UnitedHealthcare	$11 - $274	104%
Medicaid / KanCare	$14	133%
Molina Healthcare	$14	133%
Corvel/Corcare	$55 - $117	521%
Illinois Workers Compensation	$59 - $161	559%
Commercial Workers Compensation	$153	1449%
Health Alliance Mh Employee Plan	$175	1657%
Current Health Network	$209 - $285	1979%
6 Degrees Health	$228	2159%
Hope Trust	$228	2159%
Hst	$228	2159%
Cigna	$263	2491%
Aetna	$266 - $304	2519%
Healthlink	$323	3059%
Phcs/Multiplan	$342	3239%
Hfn	$361	3419%
Liability	$380	3598%

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 $380.
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 Jacksonville Memorial 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.