CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Ann & Robert H Lurie Childrens Hospital of Chicago

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $358
  • Cash Discount Price: $313
  • vs. Medicare Baseline: 33.90x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Ann & Robert H Lurie Childrens Hospital of Chicago is $358. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $313. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 33.90x the Medicare baseline. Located in 225 E Chicago Ave, Box 140, Chicago, IL.
Cash / Self-Pay
$313

Average discount available for prompt cash payment at this facility.

Insurance Median
$358

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: $313 (2964%)
Insurance Median: $358 (3390%)
Cash: $313 (2964% of Medicare)
Ins. Median: $358 (3390% 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 3390% of the Medicare baseline (a markup of 3290%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Medicare (plans) $76 - $2,656 720%
UnitedHealthcare $84 - $92 795%
Mercycare Health $165 1563%
Cigna $188 - $317 1780%
Blue Cross Blue Shield $194 - $358 1837%
Aetna $224 - $350 2121%
Beacon Health Options $224 2121%
La Rabida Childrens Hospital $224 2121%
Centegra $268 2538%
Independent Physicians At Mercy $268 2538%
Advanced Physicians Association Ipa $313 2964%
Health Plus $313 2964%
Imagine Health $313 2964%
Methodist First Choice $313 2964%
Northwest Community Healthcare $313 2964%
Presence Health Partners $313 2964%
St. Francis $313 2964%
Ui Health $313 2964%
West Suburban Health Providers $313 2964%
Shriners Hospital $335 3172%
Swedish Covenant Physician Partners $335 3172%
American Psych Systems $358 3390%
Health Alliance $358 3390%
Macneal Health $358 3390%
Magellan $358 - $900 3390%
Healthlink Inc. $369 3494%
Cofinity $380 3598%
Hfn Inc $380 - $402 3598%
Humana $380 3598%
Principal Healthcare $380 3598%
St. Elizabeth $380 3598%
First Health $393 3722%
Healthstar $393 3722%
Preferred Health Network $393 3722%
Sagamore Health Network $393 3722%
Beech Street $402 3807%
Benchmark Health $402 3807%
Employer'S Coalition On Health $402 3807%
Private Health Care System $402 3807%
Security Health Plan $402 3807%
Swedish American $402 3807%
Wellmark/Healthnetwork $411 3892%
Health Smart $425 4025%
Integrated Health Plan $425 4025%
Multiplan $425 4025%
National Provider Network $425 4025%
Wea Insurance Group $425 4025%
Unicare $3,678 - $8,500 34830%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 225 E Chicago Ave, Box 140, Chicago, IL 60611
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens