CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Ascension Providence Hospital, Southfield and Novi

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $11
Cash Discount Price: $27
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Ascension Providence Hospital, Southfield and Novi is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.04x the Medicare baseline. Located in 16001 W Nine Mile Rd, Southfield, MI.

Cash / Self-Pay

$27

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: $27 (256%)

Insurance Median: $11 (104%)

Cash: $27 (256% 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
Blue Caid Michigan	$6	57%
Harbor Health Mcd	$6	57%
Medicaid / KanCare	$6 - $11	57%
Molina Health	$6	57%
Total Health Care	$6	57%
UnitedHealthcare	$6	57%
Amerihealth Vip Care Mcr	$9 - $10	85%
Aetna	$11 - $13	104%
Auto Insurance	$11	104%
Humana	$11	104%
Jvhl - Mcr Replacement	$11	104%
Mcr Replacement	$11	104%
Meridian Wellcare	$11	104%
Molina Advantage	$11	104%
Veterans Choice	$11	104%
Ambetter / Centene	$13	123%
Molina Marketplace	$13	123%
Smarthealth Non Assigned	$13 - $14	123%
Priority Ppo	$14	133%
Smart Health	$15	142%
Hap Alliance Health	$16	152%
Hap Hmo Pos	$16	152%
Priority Health Hmo	$17	161%
Hap Preferred	$19	180%
Bc Metro Detroit Epo	$20	189%
Bc Metro Detroit Hmo	$20	189%
Bcn Local Network Southeast	$20	189%
Blue Care Network	$20	189%
Blue Cross Blue Shield	$20	189%

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 $27.
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 Ascension Providence Hospital, Southfield and Novi 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.