Comprehensive metabolic panel at Good Samaritan Hospital. CPT 80053.
What Good Samaritan Hospital publishes for this service, straight from its standard-charges file, last updated June 29, 2026.
Outpatient / ER
$168cash price (self-pay)
$168list price
$10.56–$451range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Beacon Medicare | Beacon Medicare | $10.56 |
| Hamaspik (Mcr) | Hamaspik (Mcr) | $10.56 |
| Medicare | Medicare | $10.56 |
| Medicare Managed | Medicare Managed | $10.56 |
| Mvp Gold (Mcr) | Mvp Gold (Mcr) | $10.56 |
| Emblem Ghi/Hip Medicare | Emblem Ghi/Hip Medicare | $10.77 |
| Affinity By Molina Mcr | Affinity By Molina Mcr | $11.09 |
| Health First Medicare | Health First Medicare | $11.30 |
| Beacon Exchange | Beacon Exchange | $12.67 |
| Tricare | Tricare | $13.06 |
| Beacon Commercial | Beacon Commercial | $13.73 |
| Aetna HP Network | Aetna HP Network | $18.37 |
| Aetna | Aetna | $20.38 |
| Aetna Employee | Aetna Employee | $20.38 |
| Emblem Select Care (Exchange) | Emblem Select Care (Exchange) | $26.51 |
| Emblem Ghi/Hip PPO | Emblem Ghi/Hip PPO | $31.15 |
| Geisinger Health Commercial/Exchange | Geisinger Health Commercial/Exc | $34.85 |
| Magnacare Preferred | Magnacare Preferred | $41.71 |
| Mvp Exchange | Mvp Exchange | $45.71 |
| SELF-PAY - CC 30% | SELF-PAY - CC 30 PerCent | $50.40 |
| Blue Cross Connection/Exchange | Blue Cross Connection/Exchange | $73.03 |
| Cdphp | Cdphp | $84.00 |
| Oxford Exchange | Oxford Exchange | $84.00 |
| Self-Pay - Cc 50% | Self-Pay - Cc 50 | $84.00 |
| Blue Cross Small Group | Blue Cross Small Group | $87.69 |
| Mvp HMO/PPO | Mvp HMO/PPO | $88.89 |
| Blue Cross HMO | Blue Cross HMO | $90.12 |
| Cigna PPO | Cigna PPO | $118 |
| Magnacare Standard | Magnacare Standard | $118 |
| Oxford Commercial | Oxford Commercial | $118 |
Inpatient
$168cash price (self-pay)
$168list price
$50.40–$118range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| SELF-PAY - CC 30% | SELF-PAY - CC 30 PerCent | $50.40 |
| Cdphp | Cdphp | $84.00 |
| Self-Pay - Cc 50% | Self-Pay - Cc 50 | $84.00 |
| Magnacare Standard | Magnacare Standard | $118 |
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