CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Cambridge Health Alliance

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $320
  • Cash Discount Price: $320
  • vs. Medicare Baseline: 30.30x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Cambridge Health Alliance is $320. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $320. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 30.30x the Medicare baseline. Located in 1493 Cambridge Street, Cambridge, MA.
Cash / Self-Pay
$320

Average discount available for prompt cash payment at this facility.

Insurance Median
$320

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: $320 (3030%)
Insurance Median: $320 (3030%)
Cash: $320 (3030% of Medicare)
Ins. Median: $320 (3030% 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 3030% of the Medicare baseline (a markup of 2930%). 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.

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
Boston Medical Center - Wellsense [50003] $9 85%
Fallon [50006] $9 85%
Mass General Brigham [50021] $9 - $204 85%
Mass Health [70001] $9 85%
Medicaid / KanCare $9 85%
Other Tufts Health Public Plan [75002] $9 - $17 85%
Tufts Together W Cha [75001] $9 85%
UnitedHealthcare $9 - $38 85%
Mass Bh Partnership [70098] $10 95%
Medicare (plans) $11 - $320 104%
Aarp [40001] $14 133%
Oxford Health [40004] $14 133%
United Medical Resource [40005] $14 133%
Wc [90001] $15 142%
Blue Cross Blue Shield $21 - $320 199%
Wellpoint [50012] $21 199%
Aetna $28 - $320 265%
Cigna $30 - $320 284%
Tufts Health Plan [30001] $30 - $35 284%
Health Plans Inc [20002] $38 360%
Hphc [20001] $38 360%
Multiplan [50010] $218 2064%
Altus Dental [99011] $320 3030%
Beacon Health Strategies [50002] $320 3030%
Cbhc Uninsured Crisis Alt Payer [70097] $320 3030%
Cbhc Uninsured Crisis [70096] $320 3030%
Celticare [50004] $320 3030%
Commonwealth Care Alliance Dental [99004] $320 3030%
Coverage Discovery [90004] $320 3030%
Delta Dental Of Ma [99007] $320 3030%
Dominion National Dental [99012] $320 3030%
Dph Tb Payor [85004] $320 3030%
Esp Dental [99003] $320 3030%
Eyemed Alt Payor [13001] $320 3030%
First Health [50007] $320 3030%
Global Medical Management [50024] $320 3030%
Government Employee Health Association [50023] $320 3030%
Guardian Dental [99013] $320 3030%
Health Safety Net Dental [99002] $320 3030%
Humana $320 3030%
Ma Laborers Health And Welfare Fund [50022] $320 3030%
Magellan Health Services [65098] $320 3030%
Mass Health Dental [99001] $320 3030%
Medical Mutual Of Ohio [50019] $320 3030%
Metlife Dental [99008] $320 3030%
Modern Assistance Program [30098] $320 3030%
Mva [90002] $320 3030%
Neighborhood Health Plan [50011] $320 3030%
Other Bh Payor [50014] $320 3030%
Other Commercial Payor [50015] $320 3030%
Other Dental Payor [99014] $320 3030%
Other Dual Eligible Payer [65004] $320 3030%
Other Gov'T Alt [85006] $320 3030%
Other Vision Payor [50013] $320 3030%
Ri Neighborhood Health Plan [50017] $320 3030%
Tricare $320 3030%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1493 Cambridge Street, Cambridge, MA 02139
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals