CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Blue Ridge Regional Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $5
  • Cash Discount Price: $11
  • vs. Medicare Baseline: 0.47x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Blue Ridge Regional Hospital is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 0.47x the Medicare baseline. Located in 125 Hospital Drive, Spruce Pine, NC.
Cash / Self-Pay
$11

Average discount available for prompt cash payment at this facility.

Insurance Median
$5

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: $11 (104%)
Insurance Median: $5 (47%)
Cash: $11 (104% of Medicare)
Ins. Median: $5 (47% 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.

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
Apex Health $2 19%
Blue Cross Blue Shield $2 19%
Partners Health Management $2 19%
United $2 - $5 19%
Vaya Health $2 19%
Wellcare $2 19%
Amerihealth Caritas $4 38%
Cigna $4 - $5 38%
Caresource $5 47%
Medcost $5 - $6 47%
Magellan $7 66%
Magellan Behavioral Health $7 66%
Aetna $8 76%
Multiplan $9 85%
Avalon Administrative Services $10 95%
Prime Health $10 95%
Amerihealth $11 104%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 125 Hospital Drive, Spruce Pine, NC 28777
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals