CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Atrium Health Union

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $182
Cash Discount Price: $245
vs. Medicare Baseline: 17.23x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Atrium Health Union is $182. 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 17.23x the Medicare baseline. Located in 600 Hospital Dr, Monroe, NC.

Cash / Self-Pay

$245

Average discount available for prompt cash payment at this facility.

Insurance Median

$182

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: $182 (1723%)

Cash: $245 (2320% of Medicare)

Ins. Median: $182 (1723% 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 1723% of the Medicare baseline (a markup of 1623%). 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	$9 - $182	85%
Choicecare	$9 - $416	85%
Trillium	$10 - $67	95%
Aetna	$11 - $299	104%
Alliance	$11 - $76	104%
Amerihealth Caritas	$11 - $64	104%
Carolina Complete Health	$11 - $65	104%
Cigna	$11 - $330	104%
Healthy Blue	$11 - $65	104%
Humana	$11	104%
Partners	$11 - $64	104%
UnitedHealthcare	$11 - $232	104%
Vaya	$11 - $66	104%
Wellcare	$11 - $65	104%
Ortho Carolina	$13	123%
Ambetter / Centene	$146 - $178	1383%
Employers Health Network	$216 - $259	2045%
Medcost	$264 - $318	2500%
Magellan	$294	2784%
Gmmi	$318	3011%
Quik Trip	$318	3011%
Healthgram	$392	3712%
First Health	$416	3939%
Beechstreet	$441	4176%
Private Health Care Systems	$441	4176%
Provider Select	$441	4176%
Multiplan	$465	4403%

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 $245.
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 Atrium Health Union 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.