CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Providence Holy Family Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $17
Cash Discount Price: $183
vs. Medicare Baseline: 1.61x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Providence Holy Family Hospital is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $183. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.61x the Medicare baseline. Located in 5633 North Lidgerwood, Spokane, WA.

Cash / Self-Pay

$183

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: $183 (1733%)

Insurance Median: $17 (161%)

Cash: $183 (1733% 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.

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 - $19	104%
Blue Shield	$11	104%
Kaiser	$11 - $32	104%
UnitedHealthcare	$11 - $13	104%
Amerigroup	$12	114%
Community Health Plan	$17	161%
Coordinated Care	$20	189%
Cigna	$23	218%
Providence Health Plan	$28	265%
Aetna	$45	426%

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 $183.
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 Providence Holy Family Hospital 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.