CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Charlevoix Area Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $98
Cash Discount Price: $104
vs. Medicare Baseline: 9.28x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Charlevoix Area Hospital is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $104. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 9.28x the Medicare baseline. Located in 14700 Lakeshore Drive, Charlevoix, MI.

Cash / Self-Pay

$104

Average discount available for prompt cash payment at this facility.

Insurance Median

$98

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: $104 (985%)

Insurance Median: $98 (928%)

Cash: $104 (985% of Medicare)

Ins. Median: $98 (928% 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 928% of the Medicare baseline (a markup of 828%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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 Cross Blue Shield	$7 - $113	66%
Mclaren Health Plan	$7 - $114	66%
Meridian	$7	66%
Priority Health	$7 - $122	66%
UnitedHealthcare	$7 - $106	66%
Cigna	$11 - $122	104%
Provider Network Of America/Hma Group Health	$15 - $104	142%
Hap (Health Alliance Plan)	$16 - $98	152%
Blue Care Network	$57	540%
Medicare (plans)	$57	540%
Michigan Amish Medical Board	$57	540%
Northern Michigan Mennonite Group	$57	540%
Aetna	$58 - $110	549%
Molina	$62	587%
Hospice Of Michigan	$73	691%
Employee Benefits Logistics	$97	919%
Asr Physicians Care Network	$98	928%
Enterprise Group Planning Employee Benefit Plan	$98	928%
First Health/Coventry Health/Community Care Network	$98	928%
Medical Cost Savings Solution	$98	928%
Three Rivers Provider Network	$104	985%
Iba Health And Life Assurance Company	$112	1061%
Cofinity	$113	1070%
Nomi Health	$113	1070%
Preferred Medical Claim Solutions	$116	1098%

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 $104.
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 Charlevoix Area 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.