CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Cheshire Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $45
Cash Discount Price: $103
vs. Medicare Baseline: 4.26x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Cheshire Medical Center is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $103. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 4.26x the Medicare baseline. Located in 580 Court Street, Keene, NH.

Cash / Self-Pay

$103

Average discount available for prompt cash payment at this facility.

Insurance Median

$45

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: $103 (975%)

Insurance Median: $45 (426%)

Cash: $103 (975% of Medicare)

Ins. Median: $45 (426% 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 426% of the Medicare baseline (a markup of 326%). 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 Nh	$9 - $46	85%
Granite State Health Plan	$10 - $62	95%
UnitedHealthcare	$10 - $283	95%
Wellsense Health Plan	$10 - $51	95%
Aetna	$11 - $255	104%
Ambetter / Centene	$11	104%
Blue Cross Blue Shield	$11 - $296	104%
Cigna	$11 - $185	104%
Martin'S Point Generations Advantage	$11	104%
Martin'S Point Health Care	$11	104%
Mvp	$11 - $185	104%
Wellcare Health Plans	$11	104%
Mass General Brigham Health Plan	$14 - $373	133%
Harvard Pilgrim Health Care Of Ne	$18 - $170	170%
Tufts Health Plan	$28 - $238	265%
Maine Community Health Options	$168	1591%
First Health/Hcvm	$317	3002%
Phcs	$336	3182%

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 $103.
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 Cheshire 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.