CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Forks Community Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $138
Cash Discount Price: $212
vs. Medicare Baseline: 13.07x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Forks Community Hospital is $138. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $212. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 13.07x the Medicare baseline. Located in 530 Bogachiel Way, Forks, WA.

Cash / Self-Pay

$212

Average discount available for prompt cash payment at this facility.

Insurance Median

$138

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: $212 (2008%)

Insurance Median: $138 (1307%)

Cash: $212 (2008% of Medicare)

Ins. Median: $138 (1307% 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 1307% of the Medicare baseline (a markup of 1207%). 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
UnitedHealthcare	$28 - $225	265%
Medicaid / KanCare	$92 - $97	871%
Coordinated Care (Mco) Mcd-All Plans	$99	938%
Community Health Network Mcr-All Other Plans	$119	1127%
Humana	$119	1127%
Tricare	$119	1127%
Triwest-All Plans	$119	1127%
Ambetter / Centene	$138	1307%
Wellcare Med Adv - All Plans	$138	1307%
Regence-All Other Plans	$153	1449%
Community Health Exchange	$172	1629%
Molina Commercial-All Other Plans	$244	2311%
Aetna	$252	2386%
Blue Cross Blue Shield	$252	2386%
Cigna	$265	2509%
First Choice-All Plans	$265	2509%
Medicare (plans)	$318	3011%

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 $212.
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 Forks Community 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.