CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Ohio Valley Surgical Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $21,590
  • Cash Discount Price: $88
  • vs. Medicare Baseline: 2044.51x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Ohio Valley Surgical Hospital is $21,590. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $88. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 2044.51x the Medicare baseline. Located in 100 West Main Street, Springfield, OH.
Cash / Self-Pay
$88

Average discount available for prompt cash payment at this facility.

Insurance Median
$21,590

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: $88 (833%)
Insurance Median: $21,590 (204451%)
Cash: $88 (833% of Medicare)
Ins. Median: $21,590 (204451% 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 204451% of the Medicare baseline (a markup of 204351%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Blue Cross Blue Shield $3 - $73,197 28%
UnitedHealthcare $13 - $32,489 123%
Aetna $15 - $39,629 142%
Geha $15 - $39,629 142%
Genworth $15 - $39,629 142%
Mail Handlers $15 - $39,629 142%
Meritain $15 - $39,629 142%
Meritain Heatlh $15 - $39,629 142%
Mhbp $15 - $39,629 142%
Ngs Coresource $15 - $39,629 142%
Nippon Life $15 - $39,629 142%
Pacific Source $15 - $39,629 142%
Personify Health $15 - $39,629 142%
Mmoh $66 - $21,590 625%
Mmo Cin. Hmo $67 - $92 634%
Mmoh (Supermed) $67 - $68 634%
Medicare (plans) $88 - $22,279 833%
Luminare Health $131 1241%
Medben $131 1241%
Ohio Health $131 1241%
Preferred Health $131 1241%
Aarp $21,590 204451%
Aarp Supplemental $21,590 204451%
American Continental Insurance $21,590 204451%
American Continental Life $21,590 204451%
American Republic $21,590 204451%
American Retirement $21,590 204451%
Aultcare Primetime Health Plan $21,590 204451%
Bankers Fidelity $21,590 204451%
Bankers Life And Casualty $21,590 204451%
Central States $21,590 204451%
Champus $21,590 204451%
Cigna $21,590 - $34,863 204451%
Communicare Advantage $21,590 204451%
Everest $21,590 204451%
Gateway Health Plan $21,590 204451%
Medigold $21,590 204451%
Molina $21,590 204451%
Molina Dual Mcr $21,590 204451%
Molina Marketplace $21,590 204451%
Molina Dual Mcr $21,590 204451%
Molina Mcr $21,590 204451%
Molina Mcr Mcd $21,590 204451%
Molina Mcr+Mcd $21,590 204451%
Patient No Pay $21,590 204451%
Prosperity Supplement $21,590 204451%
Self Pay Imaging $21,590 204451%
Wellcare By Allwell $21,590 204451%
Wraparound Pl Supp $21,590 204451%
Humana $22,605 214063%
The Health Plan $22,670 214678%
Devoted Health $25,995 246165%
Employer Direct $27,489 260313%
Golden Rule $31,917 302244%
Medica $31,917 302244%
Oxford $31,917 302244%
Shl $31,917 302244%
Surest $31,917 302244%
Ushealth $31,917 302244%
Caresource $32,385 306676%
Caresourse $32,385 306676%
Medicaid / KanCare $32,385 306676%
Healthgram $34,863 330142%
Nalc $34,863 330142%
Samba $34,863 330142%
Sbma $34,863 330142%
Unified Group $34,863 330142%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 West Main Street, Springfield, OH 45502
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals