Comprehensive metabolic panel at Henry Ford Providence Southfield Hospital. CPT 80053.

What Henry Ford Providence Southfield Hospital publishes for this service, straight from its standard-charges file, last updated January 1, 2026.

Outpatient / ER

$26.88cash price (self-pay)

$48.00list price

$6.12–$19.73range insurers pay

Insurance plan	Negotiated rate
Blue Caid Michigan \| 1266_sjpk,Sjpr Medicaid Replacement Blue Caid Of	$6.12
Great Lakes- UHC Community Plan \| 1247_sjpk,Sjpr Medicaid Replacement	$6.12
Harbor Health Mcd \| 1243_sjpr Medicaid Repleacement Harbor Health Outp	$6.12
Health Plan Of Mi Medicaid HMO \| 1262_sjpk,Sjpr Medicaid Replacement M	$6.12
Jvhl - Medicaid Replacement \| 1245_sjpk,Sjpr Medicaid Replacement HMO	$6.12
Medicaid \| 1263_sjpk,Sjpr Mi Medicaid Outpatient 20250101	$6.12
Medicaid Replacement \| 1242_sjpr Medicaid HMO Outpatient 20250101	$6.12
Molina Health \| 1264_sjpk,Sjpr Medicaid Replacement Molina Health Outp	$6.12
Omnicare Medicaid HMO \| 1244_sjpr Medicaid Repleacement Omnicare Outpa	$6.12
Total Health Care \| 1246_sjpk,Sjpr Medicaid Replacement Total Health C	$6.12
Amerihealth Vip Care Mcr \| 1254_sjpk,Sjpr Medicare Advantage Ameriheal	$9.08
Aetna Medicare \| 1255_sjpk,Sjpr Medicare Advantage Aetna Outpatient 20	$10.56
Auto Insurance \| 1257_sjpk,Sjpr Auto Insurance Outpatient 20250101	$10.56
Jvhl - Mcr Replacement \| 1251_sjpk,Sjpr Medicare Advantage Jvhl Outpat	$10.56
Mcr Replacement \| 1253_sjpk,Sjpr Medicare Advantage HMO Outpatient 202	$10.56
Veterans Choice \| 1256_va Optum Health Outpatient 20250101	$10.56
Humana Mcr \| 1252_sjpk,Sjpr Medicare Advantage Humana Outpatient 20250	$10.67
Meridian Wellcare \| 1250_sjpk,Sjpr Medicare Advantage Meridian Wellcar	$11.09
Molina Advantage \| 1249_sjpk,Sjpr Medicare Advantage Molina Outpatient	$11.09
Aetna \| 1203_sjpk,Sjpr Aetna PPO 20241001	$12.54
Smarthealth Non Assigned \| 1074_sjpk,Sjpr Smart Health Non Assigned 20	$13.18
Meridian Ambetter \| 1258_sjpk,Sjpr Meridian Ambetter Outpatient 202501	$13.20
Molina Marketplace \| 1259_sjpk,Sjpr Molina Marketplace Outpatient 2025	$13.20
Priority PPO \| 1105_sjpk,Sjpr Priority PPO 20210801	$14.27
Smart Health \| 1261_sjpk,Sjpr Smart Health Outpatient 20250101	$14.57
Hap Alliance Health \| 1212_sjpk,Sjpr Ahlic 20241001	$15.88
Hap HMO POS \| 1217_sjpk,Sjpr Hap HMO 20241001	$15.88
Priority Health HMO \| 1104_sjpk,Sjpr Priority HMO 20210701	$16.70
Hap Preferred \| 1210_sjpk,Sjpr Hap Preferred 20241001	$18.72
Blue Cross PPO \| 1137_sjpr Blue Cross Blue Shield PPO 20220401	$19.73

Inpatient

$26.88cash price (self-pay)

$48.00list price

$6.12–$19.73range insurers pay

Insurance plan	Negotiated rate
Amerihealth Vip Care Mcr \| 1174_sjpk,Sjpr Medicare Advantage Ameriheal	$10.45
Aetna Medicare \| 1171_sjpk,Sjpr Medicare Advantage Aetna Inpatient 202	$10.56
Auto Insurance \| 1219_sjpk,Sjpr Auto Insurance Inpatient 20241001	$10.56
Health Plan Of Mi Medicaid HMO \| 1083_sjpk,Sjpr Meridian Health Inpati	$10.56
Jvhl - Mcr Replacement \| 1180_sjpk,Sjpr Medicare Advantage Jvhl Inpati	$10.56
Jvhl - Medicaid Replacement \| 1079_sjpk,Sjpr Medicaid HMO Jvhl Inpatie	$10.56
Mcr Replacement \| 1183_sjpk,Sjpr Medicare Advantage HMO Inpatient 2024	$10.56
Veterans Choice \| 1230_va Optum Health Inpatient 20241001	$10.56
Humana Mcr \| 1177_sjpk,Sjpr Medicare Advantage Humana Inpatient 202410	$10.67
Meridian Wellcare \| 1189_sjpk,Sjpr Medicare Advantage Meridian Wellcar	$11.09
Molina Advantage \| 1192_sjpk,Sjpr Medicare Advantage Molina Inpatient	$11.09
Meridian Ambetter \| 1221_sjpk,Sjpr Meridian Ambetter Inpatient 2024100	$13.20
Molina Marketplace \| 1223_sjpk,Sjpr Molina Marketplace Inpatient 20241	$13.20
Smarthealth Non Assigned \| 1074_sjpk,Sjpr Smart Health Non Assigned 20	$14.24
Smart Health \| 1227_sjpk,Sjpr Smart Health Inpatient 20241001	$14.57

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All common services at Henry Ford Providence Southfield Hospital