CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Boston Medical Center-Brighton

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $11
Cash Discount Price: $20
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Boston Medical Center-Brighton is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.04x the Medicare baseline. Located in 736 Cambridge Street, Nevins Building, Brighton, MA.

Cash / Self-Pay

$20

Average discount available for prompt cash payment at this facility.

Insurance Median

$11

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: $20 (189%)

Insurance Median: $11 (104%)

Cash: $20 (189% of Medicare)

Ins. Median: $11 (104% 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.

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
Fallon Healthcre Aco [1121]	$9	85%
Hlth New England Aco [1123]	$9	85%
Mass General Brigham Health Plan Aco [1120]	$9	85%
Mass General Brigham Health Plan Mcd Mnged [1107]	$9	85%
Medicaid / KanCare	$9	85%
Tufts Together Aco [1122]	$9	85%
Tufts Together Mco [1125]	$9	85%
Wellsense Alli Aco [1118]	$9	85%
Wellsense Essential Mco [1101]	$9	85%
Aetna	$11 - $31	104%
Blue Cross Blue Shield	$11 - $26	104%
Cca [1215]	$11	104%
Eternalhealth [1227]	$11	104%
Humana	$11	104%
Medicare (plans)	$11	104%
Neighborhood Pace [1206]	$11	104%
Senior Whole Health [1210]	$11	104%
Ubh Hphc [8016]	$11	104%
United Community Plan [1202]	$11	104%
UnitedHealthcare	$11	104%
Veterans Admin [9003]	$11	104%
Zzzcca Onecare [1216]	$11	104%
Zzzcovid19 Hrsa Uninsured Testing And Treatment Fund [500010]	$11	104%
Cigna	$12 - $32	114%
Fallon [8008]	$14	133%
Unicare [8004]	$19	180%
Wellpoint [2034]	$19	180%
Tufts [8002]	$28 - $32	265%
Meritain Health [1023]	$31	294%
Mass General Brigham Health Plan Commercial [8009]	$34	322%
Mass General Brigham Health Plan Prime [7003]	$34	322%
Harvard Pilgrim Health Care [8001]	$39	369%
Hsn Bad Debt [4003]	$475	4498%
Hsn Confidential [4007]	$475	4498%
Hsn Dental [4006]	$475	4498%
Hsn Partial [4002]	$475	4498%
Hsn [4001]	$475	4498%

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 $20.
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 Boston Medical Center-Brighton 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.