CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Strong Memorial Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $11
Cash Discount Price: $51
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Strong Memorial Hospital is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $51. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.04x the Medicare baseline. Located in 601 Elmwood Ave, Rochester, NY.

Cash / Self-Pay

$51

Average discount available for prompt cash payment at this facility.

Insurance Median

$11

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: $51 (483%)

Insurance Median: $11 (104%)

Cash: $51 (483% of Medicare)

Ins. Median: $11 (104% 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
Medicaid / KanCare	$9 - $16	85%
Medicare (plans)	$9 - $16	85%
Mvp [2900]	$9 - $10	85%
Blue Cross Blue Shield	$10 - $12	95%
Cigna	$10	95%
Excellus [2201]	$10	95%
UnitedHealthcare	$10 - $12	95%
Capital District Physicians Health Plan (Cdphp) [51490]	$11	104%
Martins Point [1205]	$11	104%
Molina Healthcare [1723], Molina Healthcare [5189]	$12	114%
Aetna	$13 - $17	123%
Humana	$14	133%
Independent Health [5156]	$16	152%
Fidelis [5155]	$22 - $23	208%
Molina Healthcare [5189]	$23	218%

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 $51.
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 Strong Memorial Hospital 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.