CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Capital Health Medical Center - Hopewell

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $61
Cash Discount Price: $1,434
vs. Medicare Baseline: 5.78x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Capital Health Medical Center - Hopewell is $61. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,434. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 5.78x the Medicare baseline. Located in One Capital Way, Pennington, NJ.

Cash / Self-Pay

$1,434

Average discount available for prompt cash payment at this facility.

Insurance Median

$61

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: $1,434 (13580%)

Insurance Median: $61 (578%)

Cash: $1,434 (13580% of Medicare)

Ins. Median: $61 (578% 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 578% of the Medicare baseline (a markup of 478%). 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
UnitedHealthcare	$10 - $11	95%
Clover	$11	104%
Humana	$11	104%
Medicare (plans)	$11	104%
Oxford Benefit Plan	$11	104%
Wellpoint	$11 - $62	104%
Horizon Nj Health	$14	133%
Fidelis	$17	161%
Cigna	$38 - $1,076	360%
Medicaid / KanCare	$61	578%
Aetna	$77 - $509	729%
Blue Cross Blue Shield	$143 - $172	1354%
Multiplan	$1,219	11544%

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 $1,434.
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 Capital Health Medical Center - Hopewell 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.