CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Tristar Ashland City Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $12
Cash Discount Price: $2,928
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Tristar Ashland City Medical Center is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,928. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.14x the Medicare baseline. Located in 313 North Main St, Ashland City, TN.

Cash / Self-Pay

$2,928

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: $2,928 (27727%)

Insurance Median: $12 (114%)

Cash: $2,928 (27727% 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
Wellpoint	$5	47%
Aetna	$8 - $1,464	76%
Ambetter / Centene	$11	104%
American Health Advantage	$11	104%
Blue Cross Blue Shield	$11 - $2,000	104%
Bright Health	$11 - $13	104%
Devoted Health Plan	$11	104%
Evergreen Hmo	$11	104%
Healthspring	$11	104%
Humana	$11 - $732	104%
Sarah Cannon Research	$11	104%
United	$11 - $1,318	104%
Wellcare	$11	104%
Zing	$11	104%
Atrio Golden Times	$12	114%
Signature Advantage	$12	114%
Prime Health	$15	142%
Corvel Corporation	$16	152%
Novanet	$16	152%
Cigna	$19 - $914	180%
Oscar	$32	303%
Kentucky Labor Cabinet	$539	5104%
Apex Health	$556	5265%
Nhc Advantage, Inc.	$556	5265%
Pruitt Health (Allyalign)	$556	5265%
Amerigroup	$908	8598%
Bgfh Singlesource	$1,464 - $2,489	13864%
Multiplan	$1,610	15246%
Southern Health Partners	$1,757	16638%
Employers Health Network	$2,050	19413%
Odom'S Tn Pride Sausage	$2,196	20795%
Beech Street	$2,694	25511%

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 $2,928.
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 Tristar Ashland City Medical Center 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.