CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Rush Memorial Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $1,022
Cash Discount Price: $1,383
vs. Medicare Baseline: 96.78x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Rush Memorial Hospital is $1,022. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,383. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 96.78x the Medicare baseline. Located in 1300 N Main St, Rushville, IN.

Cash / Self-Pay

$1,383

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,022

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: $1,383 (13097%)

Insurance Median: $1,022 (9678%)

Cash: $1,383 (13097% of Medicare)

Ins. Median: $1,022 (9678% 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 9678% of the Medicare baseline (a markup of 9578%). 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
Health Net	$263 - $971	2491%
Caresource Mcr Adv	$277 - $1,022	2623%
My True Advantage - All Plans	$277 - $1,022	2623%
UnitedHealthcare	$277 - $2,637	2623%
Aetna	$280 - $3,033	2652%
Humana	$280 - $3,033	2652%
Blue Cross Blue Shield	$286 - $2,415	2708%
Today'S Option Mcr Adv-All Plans	$286 - $1,053	2708%
Viant Beech St Mcr Adv	$286 - $1,053	2708%
Caresource Marketplace-All Other Plans	$444 - $1,635	4205%
Cigna	$716 - $2,637	6780%
Phcs-All Plans	$716 - $2,637	6780%
Consumers Life Ins-All Plans	$805 - $2,967	7623%
Coventry/First Health-All Plans	$805 - $2,967	7623%
Sagamore-All Plans	$823 - $3,033	7794%
Siho-All Plans	$823 - $3,033	7794%
Multiplan-All Plans	$832 - $3,066	7879%
Community Health Alliance-All Plans	$841 - $3,099	7964%
Encore Health Services-All Plans	$877 - $3,231	8305%

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 $1,383.
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 Rush 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.