CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: M Health Fairview Southdale Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $131
Cash Discount Price: $84
vs. Medicare Baseline: 12.41x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at M Health Fairview Southdale Hospital is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $84. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 12.41x the Medicare baseline. Located in 6401 France Avenue South, Edina, MN.

Cash / Self-Pay

$84

Average discount available for prompt cash payment at this facility.

Insurance Median

$131

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: $84 (795%)

Insurance Median: $131 (1241%)

Cash: $84 (795% of Medicare)

Ins. Median: $131 (1241% 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 1241% of the Medicare baseline (a markup of 1141%). 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
Itasca Medical Care	$10 - $11	95%
Primewest	$10 - $11	95%
Sanford Health Plan	$10 - $136	95%
Security Health Plan	$10 - $173	95%
South Country Health Alliance	$10 - $11	95%
UnitedHealthcare	$10 - $21	95%
Wellcare	$10	95%
Blue Cross Blue Shield	$11 - $40	104%
Health Partners	$11 - $92	104%
Hennepin Health	$11 - $12	104%
Medica	$11 - $28	104%
Ucare	$11 - $24	104%
America'S Ppo	$108 - $166	1023%
First Health	$170 - $189	1610%
Multiplan	$177 - $196	1676%
Private Healthcare Systems	$177 - $196	1676%
Wisconsin Physician Services	$187 - $208	1771%

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 $84.
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 M Health Fairview Southdale 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.