CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Three Rivers Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $244
Cash Discount Price: $172
vs. Medicare Baseline: 23.11x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Three Rivers Medical Center is $244. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $172. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 23.11x the Medicare baseline. Located in 2485 Highway 644, Louisa, KY.

Cash / Self-Pay

$172

Average discount available for prompt cash payment at this facility.

Insurance Median

$244

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: $172 (1629%)

Insurance Median: $244 (2311%)

Cash: $172 (1629% of Medicare)

Ins. Median: $244 (2311% 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 2311% of the Medicare baseline (a markup of 2211%). 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	$7 - $287	66%
UnitedHealthcare	$160 - $287	1515%
Multiplan Primary Network-All Other Plans	$172	1629%
Humana	$192 - $287	1818%
Cigna	$244	2311%
Multiplan Complementary Network	$244	2311%
Aetna	$258 - $273	2443%
Wellcare Mcaid-All Plans	$302	2860%

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 $172.
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 Three Rivers Medical Center 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.