CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Portsmouth Regional Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $131
Cash Discount Price: $518
vs. Medicare Baseline: 12.41x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Portsmouth Regional Hospital is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $518. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 12.41x the Medicare baseline. Located in 333 Borthwick Ave, Portsmouth, NH.

Cash / Self-Pay

$518

Average discount available for prompt cash payment at this facility.

Insurance Median

$131

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: $518 (4905%)

Insurance Median: $131 (1241%)

Cash: $518 (4905% of Medicare)

Ins. Median: $131 (1241% 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 1241% of the Medicare baseline (a markup of 1141%). 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 - $518	104%
Blue Cross Blue Shield	$11 - $362	104%
Cigna	$11 - $56	104%
Evernorth Behavioral Health	$11	104%
Humana	$11	104%
Martin'S Point Health	$11	104%
Sierra Military Health	$11	104%
United	$11 - $540	104%
United Behavioral Health	$11	104%
United Va Ccn	$11	104%
Ambetter / Centene	$19	180%
Harvard Pilgrim	$45 - $351	426%
Maine Community Health	$68 - $433	644%
Tufts Health Plan	$82 - $468	777%
Mvp Health Plan	$153 - $573	1449%
Corvel	$157 - $589	1487%
Evernorth	$174 - $654	1648%
Mutual Of Omaha	$174 - $654	1648%
Multiplan	$177 - $663	1676%
First Health	$198 - $744	1875%
Healthcare Value Mgmt	$198 - $744	1875%
Oxford Health Plans	$207 - $777	1960%

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 $518.
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 Portsmouth Regional 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.