CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Hospital Metropolitano Dr Pila

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $17
  • Cash Discount Price: $45
  • vs. Medicare Baseline: 1.61x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Hospital Metropolitano Dr Pila is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.61x the Medicare baseline. Located in 2435 Boulevard Luis A Ferre, Ponce, PR.
Cash / Self-Pay
$45

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

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: $45 (426%)
Insurance Median: $17 (161%)
Cash: $45 (426% of Medicare)
Ins. Median: $17 (161% 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
First Medical $10 - $24 95%
Mso $10 - $11 95%
Privado $10 95%
Tricare $11 104%
Medicare (plans) $12 114%
Triple S $12 - $16 114%
Hospicio $14 133%
Humana $14 - $20 133%
Mcs $14 - $22 133%
Salud Correccional $14 133%
Ch $15 142%
Va $15 142%
Prossam $17 161%
Auxilio Mutuo $18 170%
Bl $18 170%
Fondo Del Seguro Estado $18 170%
Plan De Salud Menonita $20 - $25 189%
Aarp $23 218%
Cigna $23 218%
Mc $24 227%
Acaa $25 237%
Comerciales $30 284%
Life Link $30 284%
Wellcare $30 284%
Mapfre $55 521%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2435 Boulevard Luis A Ferre, Ponce, PR 00717
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals