CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Hospital Pavia Hato Rey, Inc

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $17
  • Cash Discount Price: $95
  • vs. Medicare Baseline: 1.61x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Hospital Pavia Hato Rey, Inc is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $95. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.61x the Medicare baseline. Located in Ave Ponce De Leon 435, Hato Rey, PR.
Cash / Self-Pay
$95

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: $95 (900%)
Insurance Median: $17 (161%)
Cash: $95 (900% 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
Mso $9 - $11 85%
First Medical $10 - $24 95%
Medicare (plans) $11 104%
Va $11 104%
Tricare $12 114%
Triple S $12 - $16 114%
Fondo Del Seguro Estado $13 123%
Plan De Salud Menonita $14 - $25 133%
Ch $15 142%
Acaa $16 152%
Humana $17 - $20 161%
Prossam $17 161%
Auxilio Salud Plus $18 170%
Bl $19 180%
Mcs $19 - $22 180%
Aarp $23 218%
Cigna $23 218%
Bella Vista $24 227%
Mc $24 227%
Privado $25 237%
Mapfre $55 521%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Ave Ponce De Leon 435, Hato Rey, PR 00919
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals