CMS Price Transparency Data
Blood test, comprehensive metabolic panel
Facility: Claiborne Memorial Medical Center
Billing Code: 80053 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80053
- Insurance Median: $65
- Cash Discount Price: $151
- vs. Medicare Baseline: 6.16x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Claiborne Memorial Medical Center is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $151. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 6.16x the Medicare baseline. Located in 620 East College Street, Homer, LA.
Cash / Self-Pay
$151
Average discount available for prompt cash payment at this facility.
Insurance Median
$65
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: $151 (1430%)
Insurance Median: $65 (616%)
Cash: $151 (1430% of Medicare)
Ins. Median: $65 (616% 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 616% of the Medicare baseline (a markup of 516%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Champus | $10 - $11 | 95% |
| Champva | $10 - $11 | 95% |
| Cigna | $10 - $114 | 95% |
| Humana | $10 - $151 | 95% |
| Kaiser Foundation Health | $10 - $11 | 95% |
| Medicare (plans) | $10 - $11 | 95% |
| Sterling Premier Mc Hmo | $10 - $11 | 95% |
| Tricare | $10 - $11 | 95% |
| Us Dept Of Labor | $10 - $11 | 95% |
| Wps Mvh Vapc3 | $10 - $11 | 95% |
| Aetna | $11 - $98 | 104% |
| Amerihealth Caritas La | $11 - $65 | 104% |
| Arcadian Community Mcr Hm | $11 | 104% |
| Blue Cross Blue Shield | $11 - $57 | 104% |
| Community Health Solution | $11 - $65 | 104% |
| Correctcare Intergrated | $11 - $65 | 104% |
| Healthy Blue | $11 - $65 | 104% |
| Healthy Blue Dual Adv | $11 | 104% |
| Louisiana Hc Connections | $11 - $65 | 104% |
| Magellan Services | $11 - $65 | 104% |
| Medicaid / KanCare | $11 - $65 | 104% |
| Peoples Health Network | $11 | 104% |
| Pyramid Claims Mcr Hmo | $11 | 104% |
| Sterling Connect 2 | $11 | 104% |
| Superior Health Mcr Hmo | $11 | 104% |
| Tenet Mcr Hmo | $11 | 104% |
| United Hc Mcr Hmo | $11 | 104% |
| UnitedHealthcare | $11 - $65 | 104% |
| Universal Hc Mcr Hmo | $11 | 104% |
| Vantage Health Mcr Hmo | $11 | 104% |
| Windsor Sterling Mcr Hmo | $11 | 104% |
| All Savers | $13 | 123% |
| Golden Rule Ins Co | $13 | 123% |
| United Behavioral Health | $13 | 123% |
| Vantage Health Plan Inc | $14 | 133% |
| Ambetter / Centene | $15 | 142% |
| Commercial Insurance | $61 - $151 | 578% |
| Meritain Health | $61 - $98 | 578% |
| Coventry Healthcare | $91 | 862% |
| Geha | $106 | 1004% |
| Health Plus Of La | $106 - $114 | 1004% |
| Apwu Healthplan | $114 | 1080% |
| Great West Healthcare | $114 | 1080% |
| Phcs | $121 | 1146% |
| Ppo Plus | $121 | 1146% |
| Sedgwick Claims Mgmt Serv | $136 | 1288% |
| Workman'S Comp | $136 | 1288% |
| Aarp | $151 | 1430% |
| Accordia National | $151 | 1430% |
| Aflac | $151 | 1430% |
| Alameda Alliance Forhealt | $151 | 1430% |
| American Pioneer | $151 | 1430% |
| Benefit Management | $151 | 1430% |
| Benesys Inc | $151 | 1430% |
| Business Guarantor | $151 | 1430% |
| Chubb | $151 | 1430% |
| Commercial Sr. Care | $151 | 1430% |
| Employee Benefit Services | $151 | 1430% |
| Family Life Insurance Co | $151 | 1430% |
| Farm Bureau Insurance | $151 | 1430% |
| Fiserv Health Benefit | $151 | 1430% |
| Gmp | $151 | 1430% |
| Group And Pension Admin | $151 | 1430% |
| Group Resources | $151 | 1430% |
| Haik Minvielle And Grubbs | $151 | 1430% |
| Harrington Benefit Svs | $151 | 1430% |
| Health Design Plus | $151 | 1430% |
| Health Plan | $151 | 1430% |
| Healthscope Benefits | $151 | 1430% |
| Insurance Management Admi | $151 | 1430% |
| Jefferson National | $151 | 1430% |
| John Alden Health Ins | $151 | 1430% |
| John Hancock | $151 | 1430% |
| Liberty Mutual | $151 | 1430% |
| Mailhandlers Benefit Plan | $151 | 1430% |
| Manhattan Life Ins Co | $151 | 1430% |
| Mega Life And Health | $151 | 1430% |
| Msa Careguard | $151 | 1430% |
| Mutual Of Omaha | $151 | 1430% |
| Nalc Health Benefit Plan | $151 | 1430% |
| Naphcare Inc. | $151 | 1430% |
| New Era Life Ins Co | $151 | 1430% |
| Physicians Mutual | $151 | 1430% |
| Principal Financial Group | $151 | 1430% |
| Prudential Healthcare | $151 | 1430% |
| Self Pay | $151 | 1430% |
| State Farm | $151 | 1430% |
| State Farm Insurance | $151 | 1430% |
| State Mutual Insurance Co | $151 | 1430% |
| Sterling Investors Life | $151 | 1430% |
| Tower Life | $151 | 1430% |
| Transamerica Premier Ins | $151 | 1430% |
| United American | $151 | 1430% |
| United Comm Travelers | $151 | 1430% |
| United Teachers | $151 | 1430% |
| Usable Administrator | $151 | 1430% |
| Visn 16 Cfu | $151 | 1430% |
| Wausau Benefits | $151 | 1430% |
| Webtpa | $151 | 1430% |
| Wells Fargo | $151 | 1430% |
| Woodmen Of The World | $151 | 1430% |