CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Riverview Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $247
Cash Discount Price: $11
vs. Medicare Baseline: 23.39x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Riverview Medical Center is $247. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 23.39x the Medicare baseline. Located in One Riverview Plaza, Red Bank, NJ.

Cash / Self-Pay

$11

Average discount available for prompt cash payment at this facility.

Insurance Median

$247

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: $11 (104%)

Insurance Median: $247 (2339%)

Cash: $11 (104% of Medicare)

Ins. Median: $247 (2339% 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 2339% of the Medicare baseline (a markup of 2239%). 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
Amerigroup	$11	104%
Clover	$11	104%
Seoul Medical Group	$11	104%
United Community/Americhoice	$11	104%
Vaccn	$11	104%
Wellcare	$11	104%
Aetna	$12 - $307	114%
UnitedHealthcare	$13 - $201	123%
Karna	$14	133%
Horizon	$17 - $275	161%
Oxford	$22	208%
Cigna	$48 - $273	455%
Blue Cross Blue Shield	$69 - $74	653%
Qualcare	$169 - $300	1600%
Bergen Risk	$238 - $256	2254%
Activecare First McO	$270 - $290	2557%
Multiplan - PHCS	$270 - $290	2557%
Brighton Health Plan	$273 - $307	2585%
Amerihealth	$275 - $334	2604%

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 $11.
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 Riverview 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.