Comprehensive metabolic panel at Froedtert Holy Family Memorial Hospital. CPT 80053.
What Froedtert Holy Family Memorial Hospital publishes for this service, straight from its standard-charges file, last updated December 31, 2025.
Outpatient / ER
$55.00cash price (self-pay)
$100list price
$10.56–$88.00range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem Blue Cross Blue Shield | Medicare Advantage | $10.56 |
| Community Care Incorporated | Medicare Advantage | $10.56 |
| Health Partners | Medicare Advantage | $10.56 |
| Humana | Medicare Advantage | $10.56 |
| ICare | Medicare Advantage | $10.56 |
| Molina | Medicare Advantage | $10.56 |
| Network Health Plan | Medicare Advantage | $10.56 |
| Security Health Plan | Medicare Advantage | $10.56 |
| United Healthcare | Medicare Advantage | $10.56 |
| Allwell | Medicare Advantage | $10.77 |
| Molina | Marketplace Plans | $11.40 |
| Network Health Plan | HMO | $12.67 |
| United Healthcare | Manitowoc Schools | $12.67 |
| United Healthcare | Nexus | $12.67 |
| United Healthcare Choice/Navigate | APA | $12.67 |
| United Healthcare Options | PPO | $12.67 |
| Anthem Blue Cross Blue Shield (Healthlink) | HMO/PPO | $13.73 |
| Health Payment Systems | All Contracted Commercial Plans | $26.40 |
| Chorus Community Health Plan | Marketplace Plans | $30.29 |
| Medical College of Wisconsin | Employee Plan | $33.00 |
| Centivo | WI 2 Median | $40.00 |
| Centivo | WI 1 Broad | $46.00 |
| Dean Health Plan | All Plans | $50.00 |
| Network Health Plan | ACA | $55.00 |
| Sheboygan Employers Health Network | All Contracted Commercial Plans | $60.00 |
| Health Partners | All Contracted Commercial Plans | $65.00 |
| Trilogy | All Contracted Commercial Plans | $66.00 |
| Cigna | All Contracted Commercial Plans | $72.00 |
| WPS Health Plan | All Contracted Commercial Plans | $74.00 |
| Aspirus | Marketplace Plans | $80.00 |
Inpatient
$55.00cash price (self-pay)
$100list price
$60.00–$88.00range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Sheboygan Employers Health Network | All Contracted Commercial Plans | $60.00 |
| Trilogy | All Contracted Commercial Plans | $66.00 |
| Cigna | All Contracted Commercial Plans | $72.00 |
| Aspirus | Marketplace Plans | $80.00 |
| HealthEos | All Contracted Commercial Plans | $80.00 |
| Multiplan/Private Healthcare Systems | All Contracted Commercial Plans | $80.00 |
| Preferred One | All Contracted Commercial Plans | $80.00 |
| Security Health Plan | All Contracted Commercial Plans | $80.00 |
| HealthSmart | All Contracted Commercial Plans | $83.00 |
| First Health Network | All Contracted Commercial Plans | $88.00 |
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All common services at Froedtert Holy Family Memorial Hospital