CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: University Medical Center of Princeton at Plainsboro

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $159
  • Cash Discount Price: $273
  • vs. Medicare Baseline: 15.06x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at University Medical Center of Princeton at Plainsboro is $159. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $273. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 15.06x the Medicare baseline. Located in One-Five Plainsboro Road, Plainsboro, NJ.
Cash / Self-Pay
$273

Average discount available for prompt cash payment at this facility.

Insurance Median
$159

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: $273 (2585%)
Insurance Median: $159 (1506%)
Cash: $273 (2585% of Medicare)
Ins. Median: $159 (1506% 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 1506% of the Medicare baseline (a markup of 1406%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $10 - $227 95%
Charity Care $10 95%
Medicaid / KanCare $10 - $273 95%
Blue Cross Blue Shield $11 - $205 104%
Cigna $11 - $273 104%
Clover Health Plan $11 104%
Humana $11 104%
Medicare (plans) $11 - $12 104%
UnitedHealthcare $11 - $29 104%
Va Medical Center $11 104%
Wellcare $12 114%
Tricare $13 123%
Us Family Health Plan $13 123%
Elap $15 - $19 142%
Centivo $19 180%
Claim Watcher $19 180%
Horizon Nj Health $23 218%
Amerihealth $28 265%
Preferred Health Care Eliance $71 672%
Horizon Behavioral Health $102 966%
Beacon Health Options $136 1288%
Magnacare $164 - $191 1553%
Princeton Theological Seminary $177 1676%
Coventry $191 1809%
Health Net $191 1809%
Beech Street $218 - $232 2064%
Intergrated Health Plan $218 2064%
Intergroup $218 2064%
Penn Global Medicine Embassy Only $218 2064%
Allied Trades $232 2197%
Consumer Health Network $232 2197%
Devon Health Services $232 2197%
First Managed Care Option $232 2197%
Ie Shaffer $232 2197%
Private Healthcare Systems $232 2197%
Qualcare $232 2197%
Total Care Network $232 2197%
Tri-State $232 2197%
Commercial Other $273 2585%
Compsych $273 2585%
Concern Plus $273 2585%
International Pfs $273 2585%
Life St. Francis $273 2585%
Magellan $273 2585%
Managed Health Network $273 2585%
Nj Carpenters $273 2585%
Penn Behavioral Health Corporate Services $273 2585%
Personnel Health Program $273 2585%
United Behavioral Health $273 2585%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One-Five Plainsboro Road, Plainsboro, NJ 08536
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals