CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Southwest Health Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $139
Cash Discount Price: $143
vs. Medicare Baseline: 13.16x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Southwest Health Center is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $143. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 13.16x the Medicare baseline. Located in 1400 East Side Rd, Platteville, WI.

Cash / Self-Pay

$143

Average discount available for prompt cash payment at this facility.

Insurance Median

$139

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: $143 (1354%)

Insurance Median: $139 (1316%)

Cash: $143 (1354% of Medicare)

Ins. Median: $139 (1316% 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 1316% of the Medicare baseline (a markup of 1216%). 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	$51 - $212	483%
Care Wisconsin	$51 - $138	483%
UnitedHealthcare	$53 - $174	502%
Dean Health Plan	$66	625%
Quartz	$105 - $165	994%
Wps	$128 - $159	1212%
Cigna	$128 - $159	1212%
Group Health Cooperative of Sc	$136 - $184	1288%
Humana	$153 - $191	1449%
Healthchoice	$162 - $201	1534%
Group Health South Central	$170 - $212	1610%
Group Health Eau Claire	$170 - $212	1610%

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 $143.
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 Southwest Health Center 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.