CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Marshfield Medical Center - Beaver Dam (Mmc-Bd)

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $114
Cash Discount Price: $188
vs. Medicare Baseline: 10.80x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Marshfield Medical Center - Beaver Dam (Mmc-Bd) is $114. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $188. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 10.80x the Medicare baseline. Located in 707 S University Ave, Beaver Dam, WI.

Cash / Self-Pay

$188

Average discount available for prompt cash payment at this facility.

Insurance Median

$114

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: $188 (1780%)

Insurance Median: $114 (1080%)

Cash: $188 (1780% of Medicare)

Ins. Median: $114 (1080% 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 1080% of the Medicare baseline (a markup of 980%). 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 - $55	104%
Group Health Cooperative Of Eau Claire	$11 - $188	104%
Humana	$11 - $176	104%
Icare	$11 - $12	104%
Managed Health Services	$11	104%
Molina Healthcare Of Wi	$11 - $168	104%
My Choice	$11	104%
Network Health Plan	$11 - $165	104%
Quartz	$11 - $113	104%
Security Health Plan (Shp)	$11 - $114	104%
Trilogy	$11 - $178	104%
UnitedHealthcare	$11 - $37	104%
Veteran'S Administration (Va Ccn)	$11	104%
The Alliance	$101	956%
Amish/Mennonite	$109	1032%
Wps Health Insurance	$133	1259%
Cigna	$135 - $147	1278%
Health Payment Systems	$138	1307%
First Health	$168	1591%
Healtheos By Multiplan Inc.	$184 - $188	1742%
Health Partners	$188	1780%
Coventry	$190	1799%

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 $188.
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 - Beaver Dam (Mmc-Bd) 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.