Comprehensive metabolic panel at Mount St. Mary's Hospital. CPT 80053.
What Mount St. Mary's Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$10.00cash price (self-pay)
$26.00list price
$7.92–$26.00range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Independent Health Medicaid [350106] | Child Health Plus Iha Medicaid | $7.92 |
| Independent Health [100165] | Iha Encompass [10016503] | $8.98 |
| Independent Health [100165] | Iha Passport [10016507] | $8.98 |
| Hospice [550001] | Niagara [55000102] | $10.00 |
| Univera Healthcare Essential [100170] | Univera Essential Plan 3 And 4 | $10.10 |
| Amerigroup [350102] | Chp BCBS Amg Mcd [35010201] | $10.10 |
| Beacon Medicaid Replacement Alt [350124] | Beacon Medicaid Alt [350124 | $10.10 |
| Fidelis Medicaid [350105] | Child Health Plus Fidelis Medicaid [350105 | $10.10 |
| Fidelis Medicaid [350105] | Fidelis [35010501] | $10.10 |
| Molina Medicaid [350107] | Affinity Molina Plus (Harp) [35010703] | $10.10 |
| Univera Healthcare Medicaid [350108] | Univera Mcd Myhealth [35010802] | $10.10 |
| Wellpoint Bc Medicaid [351102] | Wellpoint Bc Chp Non-Medicaid [351102 | $10.10 |
| Wellpoint Bc Medicaid [351102] | Wellpoint Bc Medicaid [35110201] | $10.10 |
| United Healthcare Medicaid [350101] | UHC Medicaid [35010101] | $10.30 |
| Champ Va [700002] | Champ Va [70000201] | $10.56 |
| Tricare [600100] | Wps Tricare For Life [60010001] | $10.56 |
| Va Veterans Affairs [700001] | Va Batavia [70000104] | $10.56 |
| Va Veterans Affairs [700001] | Va Ccn Optum [70000103] | $10.56 |
| Fidelis Dual Advantage [450120] | Fidelis Dual Advantage [45012001] | $10.93 |
| Humana Medicare [450130] | Humana Medicare PPO [45013003] | $11.09 |
| United Healthcare Medicare [450021] | UHC Medicare HMO [45002110] | $11.15 |
| Univera Healthcare Medicare [450124] | Senior Choice [45012401] | $11.93 |
| Univera Healthcare Essential [100170] | Univera Essential Plan 1 And 2 | $12.12 |
| Cigna [100009] | Cigna Great West [10000902] | $13.19 |
| Commercial - Other [100172] | Commercial Other [10017215] | $14.82 |
| Commercial - Other [100172] | Guardian [10017203] | $14.82 |
| Commercial - Other [100172] | Healthy Living Partnershi [10017212] | $14.82 |
| Commercial - Other [100172] | Mutual Of Omaha [10017211] | $14.82 |
| Commercial - Other [100172] | Optum Behavioral Health [10017210] | $14.82 |
| Core Source [100161] | Core Source [10016101] | $14.82 |
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