CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Elkhart General Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $44
Cash Discount Price: $47
vs. Medicare Baseline: 4.17x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Elkhart General Hospital is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 4.17x the Medicare baseline. Located in 600 E Blvd, Elkhart, IN.

Cash / Self-Pay

$47

Average discount available for prompt cash payment at this facility.

Insurance Median

$44

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: $47 (445%)

Insurance Median: $44 (417%)

Cash: $47 (445% of Medicare)

Ins. Median: $44 (417% 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 417% of the Medicare baseline (a markup of 317%). 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
Mclaren (Mi	$6	57%
UnitedHealthcare	$6 - $49	57%
Blue Cross Blue Shield	$9 - $20	85%
Aetna	$11 - $49	104%
Caresource	$11 - $95	104%
Devoted Healthcare	$11 - $15	104%
Humana	$11 - $51	104%
Mdwise	$11 - $95	104%
Mhs	$11 - $95	104%
Pace	$11	104%
Plain Church	$16 - $58	152%
Cha	$44 - $57	417%
Immergrun	$44 - $58	417%
Php	$47 - $51	445%
Cigna	$53 - $55	502%
Multiplan	$53	502%
Signature	$53	502%
Encore	$54	511%
Heartland	$73	691%

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 $47.
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 Elkhart General 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.