Comprehensive metabolic panel at Gundersen Palmer Lutheran Hospital and Clinic. CPT 80053.
What Gundersen Palmer Lutheran Hospital and Clinic publishes for this service, straight from its standard-charges file, last updated June 27, 2026.
Outpatient / ER
$71.87cash price (self-pay)
$121list price
$3.16–$117range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerigroup | Medicaid HMO | $3.16 |
| Molina Health | Managed Medicaid | $3.16 |
| Wellmark | HMO | $17.11 |
| Wellmark | Indemnity/PPO | $18.79 |
| Alliance | Premier/All Products | $40.13 |
| Alliance | Comprehensive/All Products | $40.13 |
| Quartz | All Products | $51.18 |
| Quartz | All Other Self Funded | $53.24 |
| Quartz | Self Funded | $56.87 |
| Quartz | Level Funded | $58.69 |
| UHC | All Payer Appendix | $60.02 |
| Health Partners | Medicaid HMO | $60.50 |
| Wellmark | All Products | $61.71 |
| Aetna | Medicare Advantage | $62.92 |
| Amerigroup | Medicare Advantage | $62.92 |
| Health Partners | Medicare Advantage | $62.92 |
| Humana | Medicare Advantage | $62.92 |
| Iowa Total Care | Medicaid | $62.92 |
| Managed Health Service | Managed Medicaid | $62.92 |
| Quartz | Medicare Advantage | $62.92 |
| Quartz | Medicaid_Badgercare | $62.92 |
| UHC | Medicare Advantage | $62.92 |
| Wellmark | Medicare Advantage | $62.92 |
| Quartz | Fully Insured | $65.95 |
| UCARE | Non-Dually Eligible | $66.55 |
| UCARE | Dually Eligible | $66.55 |
| UCARE | MSHO/Minnesota Special Needs | $66.55 |
| Health Partners | Medicare Cost | $72.60 |
| Medical Associates | CAH Specific | $96.80 |
| Trilogy | All Products | $96.80 |
Inpatient
$71.87cash price (self-pay)
$121list price
$51.18–$117range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Quartz | All Other Self Funded | $71.27 |
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All common services at Gundersen Palmer Lutheran Hospital and Clinic