CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Sanford Westbrook Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $201
Cash Discount Price: $197
vs. Medicare Baseline: 19.03x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Sanford Westbrook Medical Center is $201. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $197. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 19.03x the Medicare baseline. Located in 920 Bell Avenue Po Box 188, Westbrook, MN.

Cash / Self-Pay

$197

Average discount available for prompt cash payment at this facility.

Insurance Median

$201

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: $197 (1866%)

Insurance Median: $201 (1903%)

Cash: $197 (1866% of Medicare)

Ins. Median: $201 (1903% 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 1903% of the Medicare baseline (a markup of 1803%). 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	$74 - $148	701%
Sanford Health Plan Align	$105	994%
Ucare	$113 - $216	1070%
Wellmark Sd	$113	1070%
Aetna	$114 - $214	1080%
Health Partners	$114 - $197	1080%
Medicare (plans)	$114	1080%
UnitedHealthcare	$114 - $205	1080%
Primewest	$116 - $124	1098%
Security Health Plan	$135	1278%
Sanford Health Plan	$194 - $228	1837%
Medica	$216 - $233	2045%
Cigna	$221	2093%
First Choice Health Network	$221	2093%
Healthez	$221	2093%
Multiplan	$221	2093%

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 $197.
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 Sanford Westbrook Medical Center 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.