CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Hillsboro Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $12
Cash Discount Price: $58
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Hillsboro Medical Center is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $58. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.14x the Medicare baseline. Located in 335 Se 8Th Avenue, Hillsboro, OR.

Cash / Self-Pay

$58

Average discount available for prompt cash payment at this facility.

Insurance Median

$12

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: $58 (549%)

Insurance Median: $12 (114%)

Cash: $58 (549% of Medicare)

Ins. Median: $12 (114% 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
Care Oregon	$8 - $12	76%
Intercommunity Health Network	$8	76%
Kaiser Foundation Hospitals	$8 - $31	76%
Medicare (plans)	$8 - $12	76%
Pacific Source	$8 - $23	76%
Aetna	$11 - $30	104%
Community Health Plan Of Washington	$11 - $89	104%
Humana	$11	104%
Providence Health Plan	$11 - $16	104%
Samaritan Health Plan	$11	104%
Trillium	$11	104%
UnitedHealthcare	$11 - $17	104%
Health Net Health Plan Of Oregon, Inc.	$12 - $59	114%
Moda	$12 - $38	114%
Cigna	$28	265%
Blue Cross Blue Shield	$34	322%
Tuality Health	$58	549%
First Choice	$71	672%
Coventry First Health	$76	720%
Molina Exchange	$89	843%

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 $58.
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 Hillsboro Medical Center 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.