CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Tristar Greenview Regional Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $306
Cash Discount Price: $1,262
vs. Medicare Baseline: 28.98x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Tristar Greenview Regional Hospital is $306. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,262. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 28.98x the Medicare baseline. Located in 1801 Ashley Circle, Bowling Green, KY.

Cash / Self-Pay

$1,262

Average discount available for prompt cash payment at this facility.

Insurance Median

$306

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: $1,262 (11951%)

Insurance Median: $306 (2898%)

Cash: $1,262 (11951% of Medicare)

Ins. Median: $306 (2898% 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 2898% of the Medicare baseline (a markup of 2798%). 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
Humana	$10 - $394	95%
Aetna	$11	104%
Blue Cross Blue Shield	$11 - $468	104%
Coventry Cares	$11	104%
Devoted Health	$11	104%
Horizon Pace	$11	104%
Molina	$11	104%
Sarah Cannon Research	$11	104%
United	$11 - $673	104%
Va Ccn	$11	104%
Wellcare	$11 - $14	104%
Prime Health	$165 - $240	1563%
Signature Advantage	$195 - $284	1847%
Cigna	$306 - $446	2898%
Cdm Health	$503 - $733	4763%
Southern Kentucky Rehab	$770 - $1,122	7292%
Occupational Mc Alliance	$822 - $1,197	7784%
Tim Davis And Associates	$822 - $1,197	7784%
Up And Up	$822 - $1,197	7784%
Fortified Provider Network	$924 - $1,347	8750%
Multiplan	$924 - $1,347	8750%

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 $1,262.
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 Tristar Greenview Regional 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.