CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Upland Hills Health

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $117
Cash Discount Price: $225
vs. Medicare Baseline: 11.08x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Upland Hills Health is $117. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $225. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 11.08x the Medicare baseline. Located in 800 Compassion Way, Dodgeville, WI.

Cash / Self-Pay

$225

Average discount available for prompt cash payment at this facility.

Insurance Median

$117

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: $225 (2131%)

Insurance Median: $117 (1108%)

Cash: $225 (2131% of Medicare)

Ins. Median: $117 (1108% 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 1108% of the Medicare baseline (a markup of 1008%). 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
UnitedHealthcare	$4 - $9	38%
Blue Cross Blue Shield	$6 - $117	57%
Ghc Of Eau Claire	$10	95%
Ghc Of Sc Wi	$10 - $284	95%
Mhs	$10 - $117	95%
Quartz	$41	388%
Dean Health Plan	$70	663%
Humana	$117 - $376	1108%
Icare	$117	1108%
Medical Associates	$117 - $313	1108%
Security Health Plan	$117	1108%
Alliance	$236	2235%
Wps	$255 - $262	2415%
Cigna	$311 - $348	2945%
Multiplan	$367	3475%

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 $225.
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 Upland Hills Health 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.