CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: University of Iowa Health Care Medical Center Down

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $480
Cash Discount Price: $561
vs. Medicare Baseline: 45.45x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at University of Iowa Health Care Medical Center Down is $480. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $561. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 45.45x the Medicare baseline. Located in 500 E Market Street, Iowa City, IA.

Cash / Self-Pay

$561

Average discount available for prompt cash payment at this facility.

Insurance Median

$480

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: $561 (5313%)

Insurance Median: $480 (4545%)

Cash: $561 (5313% of Medicare)

Ins. Median: $480 (4545% 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 4545% of the Medicare baseline (a markup of 4445%). 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
Iowa Total Care	$10 - $11	95%
Molina Healthcare	$10	95%
Wellpoint (Amerigroup)	$10 - $11	95%
Aetna	$11 - $480	104%
Blue Cross Blue Shield	$11 - $385	104%
Healthpartners	$11 - $682	104%
UnitedHealthcare	$11 - $339	104%
Immergrun	$200	1894%
Medical Associates	$339 - $401	3210%
Quad City Community Healthcare	$401 - $602	3797%
Midlands Choice	$421 - $521	3987%
Oscar Health	$505	4782%
Great River Health Systems	$521 - $561	4934%
Aplos Health Plan	$642	6080%
Sedgwick	$642	6080%
Global Excel	$682	6458%
Sanford Health Plan	$682	6458%
Sisco	$706	6686%
Employee Benefit Systems	$722	6837%
Healthsmart	$722	6837%
Hfn	$738	6989%
Multiplan	$738	6989%

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 $561.
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 University of Iowa Health Care Medical Center Down 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.