CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Magee Memorial Hospital for Convalescents

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

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

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Magee Memorial Hospital for Convalescents is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.14x the Medicare baseline. Located in 1513 Race Street, Philadelphia, PA.

Cash / Self-Pay

$12

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: $12 (114%)

Insurance Median: $12 (114%)

Cash: $12 (114% 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
Jefferson Health Plan Aca Qhp Exchange	$10	95%
Cigna	$11	104%
Devoted Health Participation	$11	104%
Humana	$11	104%
Innovage	$11	104%
Inspira Life	$11	104%
Magee Health Partners	$11	104%
Magee Keystone Vip	$11	104%
Magee Provider Partners Health Plan	$11	104%
Medicare (plans)	$11 - $12	104%
St Agnes	$11	104%
UnitedHealthcare	$11	104%
Geisinger Health Plan	$12 - $43	114%
Highmark Wholecare Gateway	$12	114%
Magee Pa Health_Wellness	$12 - $15	114%
Perennial	$12	114%
Ibc Employee Benefit	$13	123%
Ibc Main Line Health	$13	123%
Aetna	$14 - $15	133%
Ambetter / Centene	$15	142%
Magee United	$16	152%
Magee Naphcare	$17	161%
Medicaid / KanCare	$21	199%
Magee Keystone First	$22	208%

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 $12.
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 Magee Memorial Hospital for Convalescents 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.