CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Charleston Area Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $214
Cash Discount Price: $260
vs. Medicare Baseline: 20.27x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Charleston Area Medical Center is $214. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $260. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 20.27x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$260

Average discount available for prompt cash payment at this facility.

Insurance Median

$214

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: $260 (2462%)

Insurance Median: $214 (2027%)

Cash: $260 (2462% of Medicare)

Ins. Median: $214 (2027% 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 2027% of the Medicare baseline (a markup of 1927%). 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
Aetna	$10 - $276	95%
The Health Plan Of West Virginia Inc.	$10 - $274	95%
Triwest Va	$10	95%
Unicare Health Plan Of West Virginia Inc.	$10	95%
Blue Cross Blue Shield	$11 - $257	104%
Choicecare Network	$11 - $276	104%
Optimum Choice Inc.	$11	104%
UnitedHealthcare	$11 - $276	104%
West Virginia Senior Advantage Inc.	$11	104%
Integrated Medical Solutions	$21	199%
Naphcare	$21	199%
Caresource	$26	246%
Tricare	$143 - $169	1354%
City Of Charleston	$178 - $212	1686%
Cigna	$221 - $262	2093%
Three Rivers Providers Network	$231 - $274	2188%
Healthsmart	$233 - $276	2206%
Multiplan	$233 - $276	2206%

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 $260.
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 Charleston Area 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.