CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: St Christopher's Hospital for Children

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $140
Cash Discount Price: $351
vs. Medicare Baseline: 13.26x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at St Christopher's Hospital for Children is $140. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $351. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 13.26x the Medicare baseline. Located in 160 East Erie Ave, Philadelphia, PA.

Cash / Self-Pay

$351

Average discount available for prompt cash payment at this facility.

Insurance Median

$140

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: $351 (3324%)

Insurance Median: $140 (1326%)

Cash: $351 (3324% of Medicare)

Ins. Median: $140 (1326% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1326% of the Medicare baseline (a markup of 1226%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Amerihealth Caritas	$12	114%
UnitedHealthcare	$13 - $18	123%
Geisinger	$14 - $315	133%
Cigna	$16	152%
Pa Health & Wellness	$16	152%
Aetna	$20 - $526	189%
Upmc	$21	199%
Gateway	$26	246%
Horizon Nj Health	$29	275%
Blue Cross Blue Shield	$38 - $380	360%
Health Partners	$157	1487%
Wellpoint Nj (Formerly Amerigroup)	$186	1761%

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 $351.
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 St Christopher's Hospital for Children 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.