Comprehensive metabolic panel at Ascension Saint Thomas Rutherford. CPT 80053.
What Ascension Saint Thomas Rutherford publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$179cash price (self-pay)
$597list price
$9.50–$311range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Community Plan | 1743_mttn Medicaid Replacement United Health Care Com | $9.50 |
| Community Plan | 1744_sttn Medicaid Replacement United Health Care Com | $9.50 |
| UHC | 3171_mttn UHC 20250715 | $9.50 |
| UHC | 3172_rptn UHC 20250715 | $9.50 |
| UHC | 3173_rhtn UHC 20250715 | $9.50 |
| UHC | 3174_sdtn UHC 20250715 | $9.50 |
| UHC | 3175_thtn UHC 20250715 | $9.50 |
| UHC | 3176_uhc (Sttn) 20250715 | $9.50 |
| UHC Compass/Exchange | 3165_mttn UHC Exchange 20250715 | $10.57 |
| UHC Compass/Exchange | 3166_uhc Sttn Exchange 20250715 | $10.57 |
| UHC Compass/Exchange | 3167_rptn UHC Exchange 20250715 | $10.57 |
| UHC Compass/Exchange | 3168_rhtn UHC Exchange 20250715 | $10.57 |
| UHC Compass/Exchange | 3169_sdtn UHC Compass 20250715 | $10.57 |
| UHC Compass/Exchange | 3170_thtn UHC Compass 20250715 | $10.57 |
| BCBS Tenncare Select | 2414_bcbs Blue Care Tenncare (Rutherford) 20221 | $10.95 |
| Cigna Connect | 2769_sttn Cigna Connect 20240701 | $14.78 |
| Cigna Connect | 2772_mttn Cigna Connect 20240701 | $14.78 |
| Cigna Connect | 2779_rptn Cigna Connect 20240701 | $14.78 |
| Cigna Connect | 2780_rhtn Cigna Connect 20240701 | $14.78 |
| Cigna Connect | 2784_sdtn Cigna Connect 20240701 | $14.78 |
| Aetna | 3159_sttn Aetna 20250701 | $14.97 |
| Aetna (Rutherford Only) | 3160_mttn Aetna 20250701 | $14.97 |
| Aetna Vhan | 3022_mttn Aetna Vhan 20241015 | $14.97 |
| Aetna Whole Health | 3023_mttn Aetna Whole Health 20241015 | $14.97 |
| Cigna Connect | 3148_hktn Cigna Connect 20250101 | $16.26 |
| BCBS Aca Exchange | 3147_sttn Blue Cross Blue Shield Network E 2024123 | $17.64 |
| BCBS Aca Exchange | 3146_mttn Blue Cross Blue Shield Network E 2024123 | $20.58 |
| BCBS Network E | 3149_blue Cross Blue Shield Network E Regional 202504 | $21.05 |
| Humana +51 Cpos | 2835_mttn Humana +51 Cpos 20241001 | $21.77 |
| BCBS Network L | 3151_mttn Blue Cross Blue Shield Network L 20250401 | $22.34 |
Inpatient
—cash price (self-pay)
—list price
$9.50–$14.78range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Point Comfort Underwriters | 3224_mttn Rhtn Rptn Sdtn Sttn Medicare Ad | $9.50 |
| Americhoice Medicare | 3207_mttn, Sttn Americhoice Medicare Inpatient | $9.93 |
| Ascension Complete | 3229_ascension Complete Medicare Advantage Inpati | $10.56 |
| Centurion Of Tn | 3228_medicare Advantage Centurion Of Tn Inpatient 20 | $10.56 |
| Clover Medicare Advantage | 3227_medicare Advantage Clover Inpatient 2 | $10.56 |
| Covid Uninsured Test Fund | 3202_covid Uninsured Test Fund Inpatient 2 | $10.56 |
| Healthspring Mcr Replacement | 3219_mttn Sttn Rptn Sdtn Rhtn Medicare | $10.56 |
| Humana Mcr Replacement | 3222_mttn Sttn Medicare Advantage Humana Inpa | $10.56 |
| Medicare Other | 3204_mttn Sttn Medicare Other Inpatient 20251001 | $10.56 |
| Nhc Advantage | 3225_mttn Rhtn Rptn Sdtn Sttn Medicare Advantage Nhc A | $10.56 |
| Optum Va | 3205_medicare Advantage Optum Va Inpatient 20251001 | $10.56 |
| Triwest Va Pccc | 3235_mttn Sttn Triwest Inpatient 20251001 | $10.56 |
| UHC Mcr Replacement | 3226_medicare Advantage UHC Inpatient 20251001 | $10.56 |
| Aetna Medadvantage | 3214_rptn Rhtn Sdtn Thtn Mttn Sttn Medicare Advan | $10.77 |
| Amerigroup Mcr Replacement | 3210_sttn Mttn Medicare Advantage Amerigr | $10.88 |
| BCBS Bluecare Plus | 3223_mttn Sttn Medicare Advantage Blue Cross Blue | $10.98 |
| BCBS Mcr Replacement | 3238_thtn Medicare Advantage Blue Cross Blue Sh | $11.09 |
| Windsor Medicare | 3220_mttn Sttn Medicare Advantage Wellcare (Windsor | $11.09 |
| Ambetter Of Tn | 3236_ambetter Of Tn Inpatient 20251001 | $13.73 |
| Smart Health | 3237_mttn, Rptn, Rhtn, Sdtn, Thtn Ascension Smart Healt | $14.78 |
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