CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Northwest Health - Starke

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $11
  • Cash Discount Price: $57
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Northwest Health - Starke is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $57. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.04x the Medicare baseline. Located in 102 E Culver Rd, Knox, IN.
Cash / Self-Pay
$57

Average discount available for prompt cash payment at this facility.

Insurance Median
$11

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: $57 (540%)
Insurance Median: $11 (104%)
Cash: $57 (540% of Medicare)
Ins. Median: $11 (104% 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.

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
Lutheran $3 - $107 28%
Self Pay $3 - $219 28%
Medpartners $4 - $133 38%
Alpha Baking $5 - $179 47%
Blue Cross Blue Shield $5 - $17 47%
Physicians Health Plan $5 - $164 47%
Php $7 - $239 66%
Encore $8 - $346 76%
UnitedHealthcare $8 - $281 76%
Multiplan Inc $9 - $358 85%
Aetna $10 - $344 95%
Caresource $10 - $11 95%
Cigna $10 - $330 95%
Coventry First Health $10 - $344 95%
Humana $10 - $11 95%
Lutheran Network $10 - $350 95%
Medicare (plans) $10 95%
Node Champva $10 95%
Sagamore Health Network $10 - $350 95%
Tricare $10 95%
Community Health Alliance $11 - $358 104%
In Dept Of Correction $11 104%
Managed Health Services $11 - $21 104%
Medicaid / KanCare $11 104%
Mhs $11 104%
Node Devoted Health Mcr Adv $11 104%
Node Hospice Non Par Agree $11 104%
Node Pphp Mcr Adv $11 104%
Node Va $11 104%
Ppom $11 - $374 104%
Us Department Of Labor $13 123%
Indiana Workers Comp $21 199%
Encore Kba Epo $25 237%
Magnacare Ma $25 237%
Encore Kba Ppo $32 303%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 102 E Culver Rd, Knox, IN 46534
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals