CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Franciscan Health Rensselaer, Inc

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $151
Cash Discount Price: $88
vs. Medicare Baseline: 14.30x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Franciscan Health Rensselaer, Inc is $151. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $88. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 14.30x the Medicare baseline. Located in 1104 E Grace St, Rensselaer, IN.

Cash / Self-Pay

$88

Average discount available for prompt cash payment at this facility.

Insurance Median

$151

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: $88 (833%)

Insurance Median: $151 (1430%)

Cash: $88 (833% of Medicare)

Ins. Median: $151 (1430% 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 1430% of the Medicare baseline (a markup of 1330%). 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 - $11	85%
Mdwise [1175]	$11	104%
Medicaid / KanCare	$11 - $13	104%
Unicare [1150]	$11	104%
Managed Health Services [1302]	$12	114%
Commercial [2001]	$48 - $198	455%
Managed Care [2000]	$48 - $198	455%
Medicare (plans)	$62	587%
Workers Comp [1172]	$124	1174%
United Medical Resources [1158]	$151	1430%
United Medical Resources [1301]	$151	1430%
UnitedHealthcare	$151	1430%
Aetna	$173	1638%
Cigna	$193	1828%
Great West Insurance [1055]	$193	1828%

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 $88.
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 Rensselaer, Inc 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.