CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Carilion Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $302
Cash Discount Price: $170
vs. Medicare Baseline: 28.60x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Carilion Medical Center is $302. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $170. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 28.60x the Medicare baseline. Located in 1906 Belleview Avenue, Se, Roanoke, VA.

Cash / Self-Pay

$170

Average discount available for prompt cash payment at this facility.

Insurance Median

$302

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: $170 (1610%)

Insurance Median: $302 (2860%)

Cash: $170 (1610% of Medicare)

Ins. Median: $302 (2860% 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 2860% of the Medicare baseline (a markup of 2760%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$11	104%
Sentara Health Plan	$11 - $302	104%
Abh Of Va (Formerly Coventry)	$12	114%
Abh Of Wva (Formerly Coventry)	$12	114%
Humana	$12	114%
UnitedHealthcare	$12 - $398	114%
Aetna	$248 - $323	2348%
Gateway - Tier 3	$268	2538%
Vhn - Ultra	$302	2860%
Cigna	$328 - $351	3106%
Connecticare	$341	3229%
Vhn - Plus	$375	3551%
Gateway - Tier 2	$390	3693%
Vhn	$390	3693%
Vhn - Link	$438	4148%
Gateway - Tier 1	$463	4384%
Vhn - Secondary Payors	$463	4384%

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 $170.
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 Carilion 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.