CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Johnson County Community Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $22
  • Cash Discount Price: $17
  • vs. Medicare Baseline: 2.08x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Johnson County Community Hospital is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 2.08x the Medicare baseline. Located in 1901 S Shady St, Mountain City, TN.
Cash / Self-Pay
$17

Average discount available for prompt cash payment at this facility.

Insurance Median
$22

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: $17 (161%)
Insurance Median: $22 (208%)
Cash: $17 (161% of Medicare)
Ins. Median: $22 (208% 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 208% of the Medicare baseline (a markup of 108%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Optima Health $10 95%
Aetna $11 - $48 104%
Blue Cross Blue Shield $11 - $56 104%
Molina Healthcare $11 - $23 104%
UnitedHealthcare $11 - $22 104%
Amerigroup $22 208%
Humana $22 208%
Managed Medicaire $22 208%
Medicare (plans) $22 208%
Sentara Health $22 - $25 208%
United Mine Workers Of America $22 208%
Wellcare $22 208%
Cigna $23 - $42 218%
Devoted Health Plan $23 218%
Nhc Advantage $23 218%
Ambetter / Centene $24 227%
Medcost $26 246%
First Health Coventry $56 530%
Seven Corners, Inc. $75 710%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1901 S Shady St, Mountain City, TN 37683
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals