CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Holland Community Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $18
Cash Discount Price: $50
vs. Medicare Baseline: 1.70x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Holland Community Hospital is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.70x the Medicare baseline. Located in 602 Michigan Ave, Holland, MI.

Cash / Self-Pay

$50

Average discount available for prompt cash payment at this facility.

Insurance Median

$18

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: $50 (473%)

Insurance Median: $18 (170%)

Cash: $50 (473% of Medicare)

Ins. Median: $18 (170% 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
Nomi Health - All Plans	$9	85%
UnitedHealthcare	$9 - $83	85%
Life Circles-All Plans	$10	95%
Aetna	$11 - $14	104%
Health Alliance Mcr Adv	$11	104%
Longevity Health Plan-All Plans	$11	104%
Ph Mcr Adv	$11	104%
Va Ccn - All Plans	$11	104%
Cofinity -All Plans	$13	123%
Asr - All Plans	$16	152%
Health Alliance Ahl - All Other Plans	$16	152%
Health Alliance Hmo	$16	152%
Sisco Epi	$21	199%
Sisco-All Other Plans	$21	199%
Blue Cross Blue Shield	$24	227%
Cigna	$26	246%
Molina Mcaid - All Plans	$27	256%
Ph Mcaid	$27	256%
Priority Health - All Other Plans	$28	265%
Multiplan - All Plans	$72	682%
Benefit Source Inc-All Plans	$75	710%
First Health-All Plans	$75	710%
Usa Managed Care-All Plans	$75	710%
Integrated Health Plans-All Plans	$79	748%

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 $50.
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 Holland Community Hospital 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.