CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Prisma Health Tuomey Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $17
  • Cash Discount Price: $150
  • vs. Medicare Baseline: 1.61x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Prisma Health Tuomey Hospital is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $150. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.61x the Medicare baseline. Located in 129 N Washington St, Sumter, SC.
Cash / Self-Pay
$150

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: $150 (1420%)
Insurance Median: $17 (161%)
Cash: $150 (1420% 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
Tricare $9 85%
Golden Rule Insurance Company [2991] $10 95%
Oxford Health Plans [2992] $10 95%
UnitedHealthcare $10 - $11 95%
Zzumr-Salt Lake City Ut [3169] $10 95%
Aetna $11 - $182 104%
Blue Cross Blue Shield $11 - $36 104%
Cigna $11 - $60 104%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $11 104%
Healthy Conn Prime-First Choice Vip Care [5300] $11 104%
Healthy Conn Prime-Molina Healthcare [5330] $11 104%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $11 104%
Humana $11 - $172 104%
Medicaid / KanCare $11 104%
Medicare (plans) $11 104%
Triwest Healthcare Alliance Vcp [902] $11 104%
Va Community Care Network-Vaccn [903] $11 104%
Workers Comp [600] $15 142%
Bluechoice [810] $17 - $26 161%
Planned Administrators [820] $17 161%
Ambetter / Centene $19 180%
Scdc-Sc Dept Of Corrections [7232] $36 341%
Prisma Health Seniorcare Pace - Midlands [5400] $53 502%
Prisma Health Seniorcare Pace-Upstate [5200] $53 502%
Promise Health Plan Contracted [2401] $80 - $138 758%
Orangeburg Senior Helping Center Pace [5401] $92 871%
Bob Jones Univ-Pai [821] $138 1307%
Meritain Health Contracted [2200] $147 - $182 1392%
Preferred Administrators Contracted [2839] $161 1525%
Medcost [2940] $170 - $191 1610%
Atlantic Packaging Contracted [4833] $172 1629%
Aps Healthcare System [2981] $184 1742%
Multiplan/Phcs Contracted [2950] $205 1941%
Vsp Vision Care [2986] $207 1960%
First Health Contracted [2952] $214 2027%
Furman Int/Allen University Student [2951] $214 2027%
Quiktrip-First Health [3067] $214 2027%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 129 N Washington St, Sumter, SC 29150
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals