CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Marshfield Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $171
Cash Discount Price: $191
vs. Medicare Baseline: 16.19x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Marshfield Medical Center is $171. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $191. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 16.19x the Medicare baseline. Located in 611 St Joseph Ave, Marshfield, WI.

Cash / Self-Pay

$191

Average discount available for prompt cash payment at this facility.

Insurance Median

$171

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: $191 (1809%)

Insurance Median: $171 (1619%)

Cash: $191 (1809% of Medicare)

Ins. Median: $171 (1619% 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 1619% of the Medicare baseline (a markup of 1519%). 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
Blue Cross Blue Shield	$11 - $66	104%
Group Health Cooperative Of Eau Claire	$11 - $185	104%
Security Health Plan (Shp)	$11 - $73	104%
Veteran'S Administration (Va Ccn)	$11	104%
Managed Health Services	$12	114%
UnitedHealthcare	$37	350%
Family Health Center (Fhc)	$100	947%
Amish/Mennonite	$111	1051%
Sanford Health Plan	$111	1051%
The Alliance	$140 - $168	1326%
Besse Forest Products	$171	1619%
Molina Healthcare Of Wi	$171	1619%
Rice Lake School District	$171	1619%
Wps Health Insurance	$177 - $194	1676%
Trilogy	$181 - $193	1714%
Medica Of Wi	$187 - $190	1771%
Cigna	$189	1790%
Healtheos By Multiplan Inc.	$189 - $191	1790%
Corvel	$191	1809%
First Health	$191	1809%
Health Partners	$191	1809%
Three Rivers Provider Network (Trpn)	$191	1809%
Coventry	$193	1828%
Health Smart	$193	1828%
Rising Medical Work Comp	$195	1847%

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 $191.
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 Marshfield Medical Center 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.