CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Veterans Memorial Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $244
  • Cash Discount Price: $324
  • vs. Medicare Baseline: 23.11x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Veterans Memorial Hospital is $244. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $324. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 23.11x the Medicare baseline. Located in 40 1St Street Se, Waukon, IA.
Cash / Self-Pay
$324

Average discount available for prompt cash payment at this facility.

Insurance Median
$244

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: $324 (3068%)
Insurance Median: $244 (2311%)
Cash: $324 (3068% of Medicare)
Ins. Median: $244 (2311% 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 2311% of the Medicare baseline (a markup of 2211%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Wellmark Hmo - All Other Plans $9 85%
Wellmark Ppo $10 95%
Amerigroup Mcaid - All Other Plans $11 104%
Amerigroup Mcr Adv $244 2311%
Humana $244 - $426 2311%
Iowa Total Care Exchange $244 2311%
Iowa Total Care Mcr Adv $244 2311%
Medica Mcr Adv $244 2311%
Molina Mcr Adv $244 2311%
Quartz Mcr Adv $244 2311%
UnitedHealthcare $244 - $483 2311%
Welmark Mcr Adv $244 2311%
Iowa Total Care Mcaid - All Other Plans $290 2746%
Molina Mcaid - All Other Plans $290 2746%
Quartz Comm - All Other Plans $426 4034%
Medica Comm - All Other Plans $452 4280%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 40 1St Street Se, Waukon, IA 52172
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals