CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Black River Memorial Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $245
Cash Discount Price: $239
vs. Medicare Baseline: 23.20x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Black River Memorial Hospital is $245. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $239. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 23.20x the Medicare baseline. Located in 711 W Adams St, Black River Falls, WI.

Cash / Self-Pay

$239

Average discount available for prompt cash payment at this facility.

Insurance Median

$245

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: $239 (2263%)

Insurance Median: $245 (2320%)

Cash: $239 (2263% of Medicare)

Ins. Median: $245 (2320% 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 2320% of the Medicare baseline (a markup of 2220%). 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	$6 - $136	57%
Group Health Cooperative Of Eau Claire	$11 - $258	104%
My Choice Wisconsin, Inc.	$11 - $136	104%
Quartz Health Solutions, Inc	$11 - $242	104%
UnitedHealthcare	$11 - $251	104%
Humana	$136 - $247	1288%
Security Health Plan	$136 - $248	1288%
Corvel	$162	1534%
The Alliance	$226 - $255	2140%
Triology Health Solutions	$239 - $253	2263%
Medica	$248	2348%
Association Benefits Solution	$253	2396%
Family Health Center Of Marshfield	$253	2396%
First Health Group Corporation	$253	2396%
Provider Network Of America	$253	2396%
Cigna	$258	2443%
Cofinity	$258	2443%
Coventry Health Care	$258	2443%
Custom Benefit Administrators	$258	2443%
Healthpartners, Inc.	$258	2443%
Multiplan	$258 - $263	2443%
Wisconsin Physicians Service Insurance Corp	$258	2443%
Chorus	$261	2472%

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 $239.
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 Black River Memorial Hospital 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.