CMS Price Transparency Data

Blood test, calcium

Facility: Lexington Memorial Hospital Inc

Billing Code: 82310 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82310
Insurance Median: $30
Cash Discount Price: $34
vs. Medicare Baseline: 5.81x Medicare

The contracted insurance negotiated median rate for a Blood test, calcium at Lexington Memorial Hospital Inc is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $34. Compared to the federal Medicare reimbursement reference rate of $5.16, this hospital’s rate is 5.81x the Medicare baseline. Located in 250 Hospital Drive Po Box 1817, Lexington, NC.

Cash / Self-Pay

$34

Average discount available for prompt cash payment at this facility.

Insurance Median

$30

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$5.16

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $5.16 (100%)

Cash / Self-Pay: $34 (659%)

Insurance Median: $30 (581%)

Cash: $34 (659% of Medicare)

Ins. Median: $30 (581% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $5.16 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 581% of the Medicare baseline (a markup of 481%). 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
Amerihealth	$9 - $10	174%
Carolina Complete	$9	174%
Healthy Blue	$9	174%
Partners	$9	174%
UnitedHealthcare	$9 - $30	174%
Vaya	$9	174%
Wellcare	$9	174%
Alliance	$10	194%
Ambetter / Centene	$10	194%
Blue Cross Blue Shield	$10 - $16	194%
Trillium	$10	194%
Medcost	$15 - $45	291%
Aetna	$19 - $63	368%
Oscar	$22 - $30	426%
Cigna	$30	581%
Directnet	$40	775%
Healthgram Lexington Home Brands	$49	950%
Healthgram	$54	1047%
Private Healthcare Systems	$56	1085%
Beechstreet	$60	1163%
Humana	$60	1163%
Multiplan	$61	1182%
National Provider Network	$61	1182%

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 $34.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 82310.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Lexington Memorial Hospital Inc is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 82310.
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.