CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Ascension Ne Wisconsin - St Elizabeth Campus

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $15
Cash Discount Price: $79
vs. Medicare Baseline: 1.42x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Ascension Ne Wisconsin - St Elizabeth Campus is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $79. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.42x the Medicare baseline. Located in 1506 S Oneida St, Appleton, WI.

Cash / Self-Pay

$79

Average discount available for prompt cash payment at this facility.

Insurance Median

$15

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: $79 (748%)

Insurance Median: $15 (142%)

Cash: $79 (748% of Medicare)

Ins. Median: $15 (142% 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.

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
Blue Cross Blue Shield	$11	104%
Medicare (plans)	$11	104%
Veterans Administration	$11	104%
Wellcare	$11	104%
Alliance	$15	142%
Centivo Nw1	$15 - $75	142%
Centivo Nw3	$15 - $75	142%
Smarthealth	$15	142%
Sehn	$20	189%
Molina Marketplace	$22	208%
Network Health Plan	$24	227%
Cchp	$35	331%
Cigna	$41	388%

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 $79.
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 Ascension Ne Wisconsin - St Elizabeth Campus 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.