CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Valley Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $21
Cash Discount Price: $58
vs. Medicare Baseline: 1.99x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Valley Hospital is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $58. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.99x the Medicare baseline. Located in 4 Valley Health Plaza, Paramus, NJ.

Cash / Self-Pay

$58

Average discount available for prompt cash payment at this facility.

Insurance Median

$21

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: $58 (549%)

Insurance Median: $21 (199%)

Cash: $58 (549% of Medicare)

Ins. Median: $21 (199% 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	$8 - $21	76%
Aetna	$11 - $34	104%
Humana	$11	104%
Clover	$11	104%
Medicare (plans)	$11	104%
Wellpoint	$11	104%
Horizon	$18 - $82	170%
Centivo	$20	189%
Cigna	$54 - $67	511%
Amerihealth	$67	634%
Qualcare	$72	682%

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 $58.
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 Valley 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.