CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Multicare Valley Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $13
Cash Discount Price: $48
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Multicare Valley Hospital is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $48. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.23x the Medicare baseline. Located in 12606 East Mission Avenue, Spokane Valley, WA.

Cash / Self-Pay

$48

Average discount available for prompt cash payment at this facility.

Insurance Median

$13

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: $48 (455%)

Insurance Median: $13 (123%)

Cash: $48 (455% of Medicare)

Ins. Median: $13 (123% 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
Community Health Plan Of Washington	$6 - $17	57%
Coordinated Care	$6	57%
Molina	$6 - $19	57%
UnitedHealthcare	$6 - $12	57%
Wellpoint	$6	57%
Blue Cross Blue Shield	$10	95%
Aetna	$11 - $13	104%
Premera	$11 - $13	104%
Regence	$11	104%
Wellcare	$11	104%
Pacificsource	$12 - $13	114%
Cigna	$13	123%
Kaiser	$13	123%
Regence/Asuris	$16	152%
Ambetter / Centene	$19	180%
First Choice	$46 - $83	436%
First Health	$86	814%
Multiplan/Phcs	$86	814%

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 $48.
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 Multicare Valley 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.