CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Essentia Health St Joseph's Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $149
  • Cash Discount Price: $222
  • vs. Medicare Baseline: 14.11x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Essentia Health St Joseph's Medical Center is $149. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $222. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 14.11x the Medicare baseline. Located in 523 North 3Rd Street, Brainerd, MN.
Cash / Self-Pay
$222

Average discount available for prompt cash payment at this facility.

Insurance Median
$149

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: $222 (2102%)
Insurance Median: $149 (1411%)
Cash: $222 (2102% of Medicare)
Ins. Median: $149 (1411% 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 1411% of the Medicare baseline (a markup of 1311%). 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
Advocare/Security Health $11 104%
Blue Cross Blue Shield $11 - $231 104%
Blue Plus Pmap Pcc Prime $11 - $209 104%
Freedom Blue Ppo $11 104%
Healthpartners Care Msho / Mcr Adv $11 104%
Imcare Msho Pcc Prime $11 104%
Imcare Msho Ref Req $11 104%
Itasca Med Care $11 104%
Medica Advantage Solutions $11 104%
Medica Msho/Dual Solutions $11 104%
Medica Prime Solution Group $11 104%
Medicare (plans) $11 104%
Nd Va Administration $11 104%
Platinum Blue/Vantage Blue $11 104%
Primewest $11 104%
Primewest Msho $11 104%
Secure Blue Msho $11 104%
Ubh Cost Plan $11 104%
Ubh Msho $11 104%
Ucare Msho $11 104%
UnitedHealthcare $11 - $251 104%
Medica Access $104 985%
Healthpartners Care Pmap $142 1345%
Sanford Health Plan $142 - $149 1345%
Medica $210 - $233 1989%
Medica Uplan $210 1989%
Ucare $217 2055%
Wea $238 - $254 2254%
Medica Choice $240 2273%
Cigna $243 2301%
Healthpartners $243 2301%
Healthpartners Pcc Prime $243 2301%
America'S Ppo $256 2424%
Wps $274 - $277 2595%
Aetna $280 2652%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 523 North 3Rd Street, Brainerd, MN 56401
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals