CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Stonesprings Hospital Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $41
Cash Discount Price: $1,442
vs. Medicare Baseline: 3.88x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Stonesprings Hospital Center is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,442. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 3.88x the Medicare baseline. Located in 24440 Stone Springs Boulevard, Dulles, VA.

Cash / Self-Pay

$1,442

Average discount available for prompt cash payment at this facility.

Insurance Median

$41

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: $1,442 (13655%)

Insurance Median: $41 (388%)

Cash: $1,442 (13655% of Medicare)

Ins. Median: $41 (388% 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 388% of the Medicare baseline (a markup of 288%). 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
Humana	$8 - $11	76%
Clear Spring Health Plan	$11	104%
Cigna	$11 - $42	104%
Aetna	$11	104%
Virginia Premier Health	$11	104%
Devoted	$11	104%
United	$11 - $649	104%
Align Senior Care	$11	104%
Johns Hopkins	$11	104%
Sentara Health	$11	104%
Blue Cross Blue Shield	$11 - $56	104%
Bright Health	$23	218%
Carefirst	$60	568%
Lifeworks	$274	2595%
Greenvbrier Sporting Club	$865	8191%
Virginia Health Network	$1,024	9697%
Corvel	$1,038	9830%
Three Rivers Provider Network	$1,226	11610%

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 $1,442.
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 Stonesprings Hospital 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.