CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Novant Health Forsyth Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $53
Cash Discount Price: $69
vs. Medicare Baseline: 5.02x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Novant Health Forsyth Medical Center is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 5.02x the Medicare baseline. Located in 3333 Silas Creek Parkway, Winston-Salem, NC.

Cash / Self-Pay

$69

Average discount available for prompt cash payment at this facility.

Insurance Median

$53

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: $69 (653%)

Insurance Median: $53 (502%)

Cash: $69 (653% of Medicare)

Ins. Median: $53 (502% 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 502% of the Medicare baseline (a markup of 402%). 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
Carolina Complete	$6 - $42	57%
Nc Department Of Public Safety	$6 - $42	57%
Amerihealth	$7 - $42	66%
Blue Cross Blue Shield	$7 - $161	66%
UnitedHealthcare	$7 - $151	66%
Wellcare	$7 - $42	66%
Aetna	$11 - $179	104%
Cigna	$11 - $93	104%
Humana	$11 - $174	104%
Liberty Health	$11	104%
Pace Of The Southern Piedmont	$11	104%
Caresource North Carolina	$14 - $90	133%
Atlantic Corporation Dba Atlantic Packaging	$20 - $127	189%
Plotkin Health	$21 - $134	199%
Amps	$23 - $146	218%
Medcost	$30 - $211	284%
Primary Physician Care	$31 - $197	294%
Beechstreet	$32 - $202	303%
Multiplan	$32 - $202	303%
Phcs	$32 - $202	303%
Employers Choice Network	$34 - $217	322%
Three Rivers Provider Network	$34 - $217	322%

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 $69.
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 Novant Health Forsyth 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.