CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Beloit Health System

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $172
Cash Discount Price: $101
vs. Medicare Baseline: 16.29x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Beloit Health System is $172. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $101. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 16.29x the Medicare baseline. Located in 1969 W Hart Rd, Beloit, WI.

Cash / Self-Pay

$101

Average discount available for prompt cash payment at this facility.

Insurance Median

$172

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: $101 (956%)

Insurance Median: $172 (1629%)

Cash: $101 (956% of Medicare)

Ins. Median: $172 (1629% 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 1629% of the Medicare baseline (a markup of 1529%). 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
Aetna	$11 - $333	104%
Blue Cross Blue Shield	$11 - $186	104%
Cook Children'S Health Plan (Cchp)	$11 - $175	104%
Dean Health	$11 - $196	104%
Humana	$11 - $41	104%
Independent Care Health Plan	$11	104%
Managed Health Services	$11	104%
Molina Healthcare	$11	104%
Quartz	$11 - $228	104%
UnitedHealthcare	$11 - $263	104%
Wellcare	$11	104%
Naphcare	$16	152%
The Alliance	$43 - $44	407%
Wps	$48 - $260	455%
Wea Trust	$193	1828%
Multiplan	$280	2652%
Health Eos	$312 - $319	2955%
Cigna	$322 - $333	3049%
Hfn	$322 - $333	3049%
Preferred Network Access	$322 - $333	3049%

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 $101.
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 Beloit Health System 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.