CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: St Marys Hospital Superior

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $123
  • Cash Discount Price: $218
  • vs. Medicare Baseline: 11.65x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at St Marys Hospital Superior is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $218. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 11.65x the Medicare baseline. Located in 3500 Tower Ave, Superior, WI.
Cash / Self-Pay
$218

Average discount available for prompt cash payment at this facility.

Insurance Median
$123

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: $218 (2064%)
Insurance Median: $123 (1165%)
Cash: $218 (2064% of Medicare)
Ins. Median: $123 (1165% 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 1165% of the Medicare baseline (a markup of 1065%). 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
Advocare/Security Health $11 - $94 104%
Blue Cross Blue Shield $11 - $237 104%
Freedom Blue Ppo $11 - $94 104%
Healthpartners Care Msho / Mcr Adv $11 - $94 104%
Imcare Msho Pcc Prime $11 - $94 104%
Imcare Msho Ref Req $11 - $94 104%
Itasca Med Care $11 104%
Medica Advantage Solutions $11 - $94 104%
Medica Msho/Dual Solutions $11 - $94 104%
Medica Prime Solution Group $11 - $94 104%
Medica Uplan $11 - $94 104%
Medicare (plans) $11 - $94 104%
Nd Va Administration $11 - $94 104%
Platinum Blue/Vantage Blue $11 - $94 104%
Primewest $11 104%
Primewest Msho $11 - $94 104%
Secure Blue Msho $11 - $94 104%
Ubh Cost Plan $11 - $94 104%
Ubh Msho $11 - $94 104%
Ucare Msho $11 - $94 104%
UnitedHealthcare $11 - $267 104%
Sanford Healthplan $36 - $133 341%
Blue Plus Pmap Pcc Prime $113 - $162 1070%
Healthpartners Care Pmap $119 1127%
Medica Access $119 - $185 1127%
Ucare $194 1837%
Healthpartners $199 - $235 1884%
Medica $207 - $230 1960%
Wea $212 - $227 2008%
Security Health $227 2150%
America'S Ppo $229 2169%
Cigna $230 - $235 2178%
Healthpartners Pcc Prime $230 - $235 2178%
Medica Choice $237 2244%
Wps $245 - $248 2320%
Aetna $251 2377%
Healtheos $254 2405%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3500 Tower Ave, Superior, WI 54880
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals