CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Washington Hospital, The

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $13
Cash Discount Price: $76
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Washington Hospital, The is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $76. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.23x the Medicare baseline. Located in 155 Wilson Avenue, Washington, PA.

Cash / Self-Pay

$76

Average discount available for prompt cash payment at this facility.

Insurance Median

$13

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: $76 (720%)

Insurance Median: $13 (123%)

Cash: $76 (720% of Medicare)

Ins. Median: $13 (123% 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
Aetna	$7 - $64	66%
Upmc Health Plan	$8 - $11	76%
Blue Cross Blue Shield	$10 - $24	95%
Health Plan Of Upper Ohio Valley	$11 - $79	104%
Highmark Wholecare (Prev Gateway)	$11 - $13	104%
Humana	$11	104%
Senior Life	$11	104%
Amerihealth Caritas	$12	114%
UnitedHealthcare	$13	123%
Cigna	$15	142%
City Of Washington	$21	199%
Peak Health	$81	767%
Coventry/First Health	$84	795%

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 $76.
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 Washington Hospital, The 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.