CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: St Mary Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $21
  • Cash Discount Price: $438
  • vs. Medicare Baseline: 1.99x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at St Mary Medical Center is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $438. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.99x the Medicare baseline. Located in Langhorne-Newtown Rd, Langhorne, PA.
Cash / Self-Pay
$438

Average discount available for prompt cash payment at this facility.

Insurance Median
$21

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: $438 (4148%)
Insurance Median: $21 (199%)
Cash: $438 (4148% of Medicare)
Ins. Median: $21 (199% 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
Aetna $11 - $231 104%
Align Senior Care $11 104%
Blue Cross Blue Shield $11 - $128 104%
Cigna $11 - $57 104%
Medicare (plans) $11 - $19 104%
Health America Advantra $13 123%
Medicaid / KanCare $13 - $28 123%
Ambetter / Centene $19 180%
Jefferson Health Plan Commercial $19 180%
Oscar $19 180%
Prime Healthcare $19 180%
UnitedHealthcare $19 - $125 180%
Homestead Health Plans Woods Center $21 199%
Group Pension Administrators $24 227%
Reedman Toll $24 227%
Pace-Trinity Health $26 246%
Keystone First $28 265%
Keystone First Chip $28 265%
Blue Shield - Pa (Highmark) $29 275%
Amerihealth $50 473%
Blue Shield - Ca $50 473%
Blue Shield - Id (Regence) $50 473%
Blue Shield - Ny Highmark Western $50 473%
Blue Shield - Wa (Regence) $50 473%
Upmc Health Plan $57 540%
Webtpa $57 540%
Geha $106 1004%
Meritain $231 2188%
Multiplan $233 2206%
Prime Health Services $233 2206%
Galaxy Health Network $246 2330%
Three Rivers Provider Network $246 2330%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Langhorne-Newtown Rd, Langhorne, PA 19047
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals