CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Rehabilitation Hospital of Wisconsin

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $233
  • Cash Discount Price: $292
  • vs. Medicare Baseline: 22.06x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Rehabilitation Hospital of Wisconsin is $233. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $292. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 22.06x the Medicare baseline. Located in 1625 Coldwater Creek Dr, Waukesha, WI.
Cash / Self-Pay
$292

Average discount available for prompt cash payment at this facility.

Insurance Median
$233

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: $292 (2765%)
Insurance Median: $233 (2206%)
Cash: $292 (2765% of Medicare)
Ins. Median: $233 (2206% 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 2206% of the Medicare baseline (a markup of 2106%). 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
Alliance Ppo $140 - $263 1326%
Dean Ppo Hmo/Pos $140 - $263 1326%
Medica (Under Dean) $140 - $263 1326%
UnitedHealthcare $142 - $382 1345%
Trilogy Ppo $146 - $382 1383%
Wps "Insurance" Ppo $148 - $279 1402%
Phcs Savility $152 - $286 1439%
Hps Solutions Ppo $154 - $290 1458%
Aetna $158 - $382 1496%
Health Eos Poc $162 - $305 1534%
Coventry/First Health Ppo $166 - $313 1572%
Hps (Other) $166 - $313 1572%
Health Eos Multiplan $173 - $324 1638%
Phcs / Multiplan $187 - $351 1771%
All Savers $203 - $382 1922%
Blue Cross Blue Shield $203 - $382 1922%
Centivo Broad $203 - $382 1922%
Centivo Intermediate/Median $203 - $382 1922%
Centivo Narrow/Value $203 - $382 1922%
Children'S Communty Health Plan(Cchp) $203 - $382 1922%
Cigna $203 - $382 1922%
Community Care, Inc $203 - $382 1922%
Humana $203 - $382 1922%
Icare Mcd $203 - $382 1922%
Managed Health Services (Mhs) $203 - $382 1922%
Medicaid / KanCare $203 - $382 1922%
Medicare (plans) $203 - $382 1922%
Molina (Fka Care Wisconsin) $203 - $382 1922%
Network Health - Aca $203 - $382 1922%
Network Health - Commercial $203 - $382 1922%
Quartz (Self Funded) / Unity Health Plan (Hmo/Pos) $203 - $382 1922%
Security Health Plan - Advocare $203 - $382 1922%
Together With Cchp $203 - $382 1922%
Unity Health Plan And Unity Quartz(Hmo/Pos) $203 - $382 1922%
Va - Primary Only - Authorization Required $203 - $382 1922%
Wellcare Mcr $203 - $382 1922%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1625 Coldwater Creek Dr, Waukesha, WI 53188
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL