CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Englewood Hospital and Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $37
Cash Discount Price: $40
vs. Medicare Baseline: 3.50x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Englewood Hospital and Medical Center is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 3.50x the Medicare baseline. Located in 350 Engle St, Englewood, NJ.

Cash / Self-Pay

$40

Average discount available for prompt cash payment at this facility.

Insurance Median

$37

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: $40 (379%)

Insurance Median: $37 (350%)

Cash: $40 (379% of Medicare)

Ins. Median: $37 (350% 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 350% of the Medicare baseline (a markup of 250%). 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
Oxford_741	$4	38%
UnitedHealthcare	$4 - $11	38%
Americhoice_756	$10	95%
Heathnet Federal Services	$10	95%
Hip Health Plan	$10	95%
Horizon New Jersey Health - Dsnp	$10 - $11	95%
Aetna	$11 - $197	104%
Americhoice_732	$11	104%
Amerigroup_758	$11	104%
Amerihealth_766	$11	104%
Blue Cross Blue Shield	$11 - $232	104%
Clover_733	$11	104%
Emblem_734	$11	104%
Humana	$11	104%
Wellcare_765	$11	104%
Emblem_762	$12	114%
Health Care Support_787	$18	170%
Amerihealth_760	$19	180%
Wellcare_755	$31	294%
Amerigroup_754	$39	369%
Magnacare_768	$39	369%
Magnacare_770	$39	369%
Amerihealth_757	$184	1742%
Multiplan	$192 - $196	1818%
Cigna	$215	2036%
Horizon	$234 - $250	2216%
Magnacare_763	$240	2273%
Magnacare_769	$240	2273%
Qualcare_752	$264	2500%
Qualcare	$268	2538%
Bergen	$300	2841%
Coventry	$300	2841%
Magnacare	$320	3030%
Qualcare_783	$7,783	73703%

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 $40.
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 Englewood Hospital and 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.