CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Mary Hitchcock Memorial Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $20
Cash Discount Price: $49
vs. Medicare Baseline: 1.89x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Mary Hitchcock Memorial Hospital is $20. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.89x the Medicare baseline. Located in 1 Medical Center Drive, Lebanon, NH.

Cash / Self-Pay

$49

Average discount available for prompt cash payment at this facility.

Insurance Median

$20

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: $49 (464%)

Insurance Median: $20 (189%)

Cash: $49 (464% of Medicare)

Ins. Median: $20 (189% 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.

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
UnitedHealthcare	$4 - $124	38%
Blue Cross Blue Shield	$7 - $140	66%
Amerihealth Caritas Nh	$9 - $18	85%
Beacon Health Strategies/Carelon	$9 - $20	85%
Granite State Health Plan	$9 - $20	85%
Wellsense Health Plan	$9 - $20	85%
Aetna	$11 - $113	104%
Ambetter / Centene	$11 - $35	104%
Cigna	$11 - $110	104%
Harvard Pilgrim Health Care Of Ne	$11 - $103	104%
Martin'S Point Generations Advantage	$11	104%
Martin'S Point Health Care	$11 - $56	104%
Mvp	$11 - $108	104%
Wellcare Health Plans	$11	104%
Mass General Brigham Health Plan	$25 - $100	237%
Tufts Health Plan	$31 - $94	294%
Maine Community Health Options	$103 - $118	975%
Coventry	$140	1326%
First Health/Hcvm	$140	1326%
Phcs	$145	1373%
Corvel	$148	1402%
Ccmsi	$153	1449%

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 $49.
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 Mary Hitchcock Memorial Hospital 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.