CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Franciscan Health Michigan City

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $298
Cash Discount Price: $103
vs. Medicare Baseline: 28.22x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Franciscan Health Michigan City is $298. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $103. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 28.22x the Medicare baseline. Located in 3500 Franciscan Way, Michigan City, IN.

Cash / Self-Pay

$103

Average discount available for prompt cash payment at this facility.

Insurance Median

$298

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: $103 (975%)

Insurance Median: $298 (2822%)

Cash: $103 (975% of Medicare)

Ins. Median: $298 (2822% 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 2822% of the Medicare baseline (a markup of 2722%). 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 - $248	85%
Mdwise [1175]	$11	104%
Medicaid / KanCare	$11 - $13	104%
Medicare (plans)	$11	104%
Unicare [1150]	$11	104%
Managed Health Services [1302]	$12	114%
Aetna	$18 - $32	170%
Managed Care [2000]	$18 - $447	170%
Workers Comp [1172]	$21	199%
Commercial [2001]	$48 - $497	455%
United Medical Resources [1158]	$298	2822%
United Medical Resources [1301]	$298 - $331	2822%
UnitedHealthcare	$298 - $331	2822%
Cigna	$300 - $348	2841%
Great West Insurance [1055]	$300	2841%

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 $103.
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 Franciscan Health Michigan City 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.