CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Carolina East Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $92
Cash Discount Price: $73
vs. Medicare Baseline: 8.71x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Carolina East Medical Center is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $73. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 8.71x the Medicare baseline. Located in 2000 Neuse Blvd, New Bern, NC.

Cash / Self-Pay

$73

Average discount available for prompt cash payment at this facility.

Insurance Median

$92

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: $73 (691%)

Insurance Median: $92 (871%)

Cash: $73 (691% of Medicare)

Ins. Median: $92 (871% 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 871% of the Medicare baseline (a markup of 771%). 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
Humana	$11	104%
Inclusive Health (Nchirp)-All Plans	$11	104%
Tricare	$11 - $291	104%
Pamlico Co Jail-All Plans	$17 - $77	161%
Craven Co. Jail Systems - All Plans	$21 - $98	199%
UnitedHealthcare	$22 - $207	208%
Medcost Ppo Employees And Retirees	$42 - $191	398%
Medcost Ppo Ultra (Employees)	$42 - $182	398%
Blue Cross Blue Shield	$45 - $200	426%
Medcost Ppo City Employees	$47 - $212	445%
Medcost Ppo County Employee	$48 - $220	455%
Benefit Mgmt, Svcs-All Plans	$54 - $247	511%
Aetna	$57 - $258	540%
Medcost Benefit Svc-All Other Plans	$57 - $257	540%
Acs Consult Svc Inc-All Plans	$58 - $263	549%
Cigna	$58 - $265	549%
Medcost Ppo Standard	$58 - $263	549%

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 $73.
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 Carolina East 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.