CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Carolinas Medical Center-Northeast

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $201
  • Cash Discount Price: $245
  • vs. Medicare Baseline: 19.03x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Carolinas Medical Center-Northeast is $201. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $245. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 19.03x the Medicare baseline. Located in 920 Church St N, Concord, NC.
Cash / Self-Pay
$245

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: $245 (2320%)
Insurance Median: $201 (1903%)
Cash: $245 (2320% 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.

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
Blue Cross Blue Shield $9 - $176 85%
Choicecare $9 - $401 85%
Partners $10 - $62 95%
Trillium $10 - $63 95%
Aetna $11 - $299 104%
Alliance $11 - $62 104%
Amerihealth Caritas $11 - $60 104%
Carolina Complete Health $11 - $61 104%
Cigna $11 - $392 104%
Healthy Blue $11 - $61 104%
Humana $11 104%
UnitedHealthcare $11 - $217 104%
Vaya $11 - $62 104%
Wellcare $11 - $61 104%
Ortho Carolina $13 123%
Ambetter / Centene $142 - $178 1345%
Employers Health Network $216 - $259 2045%
Physician Reach Out $245 2320%
Medcost $263 - $367 2491%
Magellan $294 2784%
Gmmi $318 3011%
Quik Trip $318 3011%
Carolina Behavioral Health $352 - $392 3333%
Healthgram $392 3712%
Private Health Care Systems $392 3712%
Lifesynch Community Choice Care $401 3797%
First Health $416 3939%
Beechstreet $441 4176%
Multiplan $465 4403%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 920 Church St N, Concord, NC 28025
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals