CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Indiana Regional Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $15
  • Cash Discount Price: $58
  • vs. Medicare Baseline: 1.42x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Indiana Regional Medical Center is $15. 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 1.42x the Medicare baseline. Located in 835 Hospital Road, Indiana, PA.
Cash / Self-Pay
$58

Average discount available for prompt cash payment at this facility.

Insurance Median
$15

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: $15 (142%)
Cash: $58 (549% of Medicare)
Ins. Median: $15 (142% 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.

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
Highmark $7 - $33 66%
Highmark Wholecare $7 - $11 66%
Aetna $10 - $32 95%
Humana $10 95%
Tricare $10 - $166 95%
Ambetter / Centene $11 - $16 104%
Amerihealth Caritas $11 - $15 104%
Cigna $11 - $33 104%
Geisinger Health Plan $11 - $15 104%
Medicare (plans) $11 104%
United Mine Workers Of America $11 104%
UnitedHealthcare $11 - $66 104%
Upmc Health Plan $11 - $93 104%
Geisinger $15 - $30 142%
Pa Health And Wellness Commercial $15 - $30 142%
Department Of Human Services And Torrance State Hospital $100 - $105 947%
Premier Comp Solutions, Llc $142 - $149 1345%
Miscellaneous Commercial $158 - $166 1496%
Pa Workers Compensation $158 - $166 1496%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 835 Hospital Road, Indiana, PA 15701
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals