CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Montefiore St Luke's Cornwall

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $16
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.52x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Montefiore St Luke's Cornwall is $16. 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 1.52x the Medicare baseline. Located in 70 Dubois Street, Newburgh, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$16

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: $16 (152%)

Ins. Median: $16 (152% 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
Fidelis	$8 - $12	76%
Aetna	$10 - $16	95%
Blue Cross Blue Shield	$10 - $566	95%
Cdphp	$10	95%
Centerlight	$10	95%
Emblem	$10 - $574	95%
Hudson Valley	$10	95%
Mediblue	$10	95%
Medicaid / KanCare	$10	95%
Oscar	$10	95%
Point Comfort	$10	95%
UnitedHealthcare	$10 - $13	95%
Humana	$11	104%
American Postal Workers	$13	123%
Mvp	$14	133%
Geha	$16	152%
Meritain Health	$16	152%
Nippon Life Insurance	$16	152%
Northwell	$27	256%
Healthfirst	$67	634%
Cigna	$93 - $104	881%
Centivo	$452	4280%
Seiu1199	$538	5095%

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 $X.
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 Montefiore St Luke's Cornwall 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.