CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Nationwide Children's Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $149
Cash Discount Price: $146
vs. Medicare Baseline: 14.11x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Nationwide Children's Hospital is $149. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $146. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 14.11x the Medicare baseline. Located in 700 Children's Drive, Columbus, OH.

Cash / Self-Pay

$146

Average discount available for prompt cash payment at this facility.

Insurance Median

$149

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: $146 (1383%)

Insurance Median: $149 (1411%)

Cash: $146 (1383% of Medicare)

Ins. Median: $149 (1411% 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 1411% of the Medicare baseline (a markup of 1311%). 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
Amerihealth	$30	284%
Bchp	$30	284%
Blue Cross Blue Shield	$30 - $155	284%
Caresource	$30 - $78	284%
Humana	$30 - $157	284%
Molina	$30	284%
UnitedHealthcare	$30 - $157	284%
Mmo	$137 - $142	1297%
Aetna	$143 - $157	1354%
Ohg	$143 - $148	1354%
Ohio Ppo Connect	$145 - $153	1373%
Osu	$145 - $153	1373%
Ohc	$148 - $153	1402%
Ahpo	$149 - $155	1411%
Cigna	$149 - $155	1411%
Front Path Health Coalition	$149 - $155	1411%
Unicare	$151 - $157	1430%
The Health Plan	$153 - $158	1449%
Emerald Health	$156 - $162	1477%
First Health	$156 - $162	1477%
Phcs	$156 - $162	1477%

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 $146.
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 Nationwide Children's 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.