CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Stoughton Hospital

Billing Code: 80053 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$32

about 2.9× the $11 Medicare rate · typically $10–$74

modeled estimate · not a bill or quote

Medicare pays $11 Fair price $32 Cash price $183 Hospital's list price $332

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$146 - $266	1383%
Blue Cross Blue Shieldmajor	$289	2737%
Aetnamajor	$100 - $282	947%
Cignamajor	$266	2519%
Humanamajor	$93 - $299	881%
Dean Health Plan	$59 - $93	559%
GEHA	$249	2358%
Health Net	$88	833%
Quartz	$68 - $93	644%
+ 2 smaller / regional plans	$35 - $299

Government programs also on file: Medicaid, Military & VA.

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 183), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 80053.

Insurance Before you use insurance

Call your insurance company to confirm Stoughton Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 80053.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Stoughton Hospital

Compare: Blood test, comprehensive metabolic panel at other WI hospitals

Insurance negotiated median for the same procedure, sorted lowest first.