CMS Price Transparency Data
Blood test, comprehensive metabolic panel
Facility: St Francis Hospital - the Heart Center
Billing Code: 80053 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80053
- Insurance Median: $21
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.99x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at St Francis Hospital - the Heart Center is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.99x the Medicare baseline. Located in 100 Port Washington Boulevard, Roslyn, NY.
Cash / Self-Pay
Unavailable
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%)
Insurance Median: $21 (199%)
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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Affinity Health Plan | $10 - $23 | 95% |
| Blue Cross Blue Shield | $10 - $39 | 95% |
| Centerlight Healthcare | $10 - $11 | 95% |
| Elderplan Inc. | $10 - $11 | 95% |
| Emblem Health | $10 - $24 | 95% |
| Fidelis Care New York | $10 - $23 | 95% |
| Health First | $10 - $24 | 95% |
| Health Plus | $10 - $23 | 95% |
| Independent Health | $10 - $11 | 95% |
| Medicaid / KanCare | $10 | 95% |
| Mvp Health Plans | $10 - $26 | 95% |
| Senior Whole Health | $10 - $11 | 95% |
| UnitedHealthcare | $10 - $39 | 95% |
| Aetna | $11 - $13 | 104% |
| Agewell New York | $11 | 104% |
| Centers Plan For Healthy Living | $11 | 104% |
| Healthspring | $11 | 104% |
| Humana | $11 | 104% |
| Liberty Health | $11 | 104% |
| Longevity Health Plan | $11 | 104% |
| Medicare (plans) | $11 | 104% |
| Orthonet - Uniformed Services Family Health Plan | $11 | 104% |
| Partners Health Plan | $11 | 104% |
| Pmc | $11 | 104% |
| Surest | $11 | 104% |
| Tricare | $11 | 104% |
| Universal Healthcare | $11 | 104% |
| Us Family Health Plan | $11 | 104% |
| Veterans Affairs | $11 | 104% |
| Wellcare Health Plan Inc | $12 | 114% |
| Mail Handlers Benefit Plan | $13 | 123% |
| Meritain Health | $13 | 123% |
| Nippon Life Insurance Company Of America | $13 | 123% |
| Salvation Army | $13 | 123% |
| Zadroga | $14 | 133% |
| Centivo | $16 - $26 | 152% |
| American Plan Administrators | $24 | 227% |
| Amerihealth Administrators | $24 | 227% |
| Benefit Services | $24 | 227% |
| Ghi Cbp Ny City Employee Alternate | $24 | 227% |
| International Benefit Administrator | $24 | 227% |
| Ultra Benefits Inc. | $24 | 227% |
| Apwu | $26 | 246% |
| Cigna | $26 - $409 | 246% |
| Daniel H Cook | $26 | 246% |
| Nalc | $26 | 246% |
| Samba | $26 | 246% |
| Brighton | $27 - $409 | 256% |
| Self Pay | $39 | 369% |
| Local 1199 | $48 | 455% |
| Oscar Health | $162 - $239 | 1534% |
| Allied Wellfare Fund | $276 - $409 | 2614% |
| American Group Administrators | $276 - $409 | 2614% |
| Bakery & Confectionery Union | $276 - $409 | 2614% |
| Comprehensive Benefits Consultant | $276 - $409 | 2614% |
| Guardian Life Insurance Company Of America | $276 - $409 | 2614% |
| Maloney And Assoc | $276 - $409 | 2614% |
| Multiplan | $276 - $409 | 2614% |
| Performax | $276 - $409 | 2614% |
| Phcs | $276 - $409 | 2614% |
| Pomco | $276 - $409 | 2614% |
| Tpa Inc | $276 - $409 | 2614% |
| Unicare | $276 - $409 | 2614% |
| United Employees Health Plan | $276 - $409 | 2614% |
| Coventry | $292 - $485 | 2765% |
| Galaxy | $355 - $526 | 3362% |
| Three Rivers Provider Network | $355 - $526 | 3362% |
| Aither Health | $394 - $584 | 3731% |
| Alpha Care | $394 - $584 | 3731% |
| Dentaquest | $394 - $584 | 3731% |