CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Frisbie Memorial Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $89
Cash Discount Price: $504
vs. Medicare Baseline: 8.43x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Frisbie Memorial Hospital is $89. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $504. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 8.43x the Medicare baseline. Located in 11 Whitehall Road, Rochester, NH.

Cash / Self-Pay

$504

Average discount available for prompt cash payment at this facility.

Insurance Median

$89

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: $504 (4773%)

Insurance Median: $89 (843%)

Cash: $504 (4773% of Medicare)

Ins. Median: $89 (843% 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 843% of the Medicare baseline (a markup of 743%). 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 Caritas	$9	85%
Well Sense Health Plan	$10	95%
Aetna	$11 - $291	104%
Blue Cross Blue Shield	$11 - $202	104%
Cigna	$11 - $232	104%
Evernorth Behavioral Health	$11	104%
Humana	$11	104%
Martin's Point Health	$11	104%
United	$11 - $304	104%
United VA Ccn	$11	104%
Ambetter / Centene	$19	180%
Harvard Pilgrim	$134 - $204	1269%
Maine Community Health	$144 - $244	1364%
Tufts Health Plan	$173 - $288	1638%
Evernorth	$403	3816%

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 $504.
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 Frisbie 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.