CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: University of Wi Hospitals & Clinics Authority

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $221
  • Cash Discount Price: $227
  • vs. Medicare Baseline: 20.93x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at University of Wi Hospitals & Clinics Authority is $221. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $227. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 20.93x the Medicare baseline. Located in 600 Highland Avenue, Madison, WI.
Cash / Self-Pay
$227

Average discount available for prompt cash payment at this facility.

Insurance Median
$221

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: $227 (2150%)
Insurance Median: $221 (2093%)
Cash: $227 (2150% of Medicare)
Ins. Median: $221 (2093% 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 2093% of the Medicare baseline (a markup of 1993%). 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
Aetna $11 - $304 104%
Blue Cross Blue Shield $11 - $360 104%
Humana $11 104%
Medicare (plans) $11 104%
UnitedHealthcare $11 - $237 104%
Alliance_Premier_Network $181 1714%
Mercycare $188 1780%
Triology $193 - $231 1828%
Security_Health_Plan $205 - $241 1941%
Employer'S_Coalition_On_Health $208 - $292 1970%
Alliance $213 2017%
Hfn $216 - $292 2045%
United_Healthcare $217 - $322 2055%
Beloit_Health_System $220 2083%
Aspirus_Health_Plan $221 2093%
Cigna $227 2150%
Health_Partners_Insurance $231 2188%
Health_Payment_Systems $232 2197%
Dean_Health_Plan $243 2301%
Medical_Associates $250 2367%
Wps $263 - $289 2491%
Employers_Healthcare_Coalition_Of_Wi $265 2509%
Aspirus_Network_Inc $292 2765%
Chorus_Community $303 2869%
Ghc_Eau_Claire_Health_Plan $303 2869%
Multiplan $303 - $349 2869%
Sheybogan_Employers_Health_Network $303 2869%
Coventry $322 3049%
Dean_Care $322 3049%
Healthsmart $334 3163%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 Highland Avenue, Madison, WI 53792
  • CMS Rating: ★★★★★
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals