Comprehensive metabolic panel at Gundersen TriCounty Hospital and Clinics. CPT 80053.
What Gundersen TriCounty Hospital and Clinics publishes for this service, straight from its standard-charges file, last updated June 27, 2026.
Outpatient / ER
$54.52cash price (self-pay)
$86.00list price
$3.16–$161range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerigroup | Medicaid HMO | $3.16 |
| Anthem | Medicaid | $15.54 |
| Group Health Eau Claire | Medicaid HMO | $15.54 |
| Group Health of South Central | Medicaid HMO | $15.54 |
| Iowa Total Care | Medicaid | $15.54 |
| Managed Health Service | Managed Medicaid | $15.54 |
| Quartz | Medicaid_Badgercare | $15.54 |
| Quartz | All Products | $36.38 |
| Quartz | All Other Self Funded | $37.84 |
| Quartz | Self Funded | $40.42 |
| Quartz | Level Funded | $41.71 |
| UCARE | Non-Dually Eligible | $44.72 |
| UCARE | MSHO/Minnesota Special Needs | $44.72 |
| UCARE | Dually Eligible | $44.72 |
| Quartz | Fully Insured | $46.87 |
| Anthem | Medicare HMO/PPO | $50.74 |
| Humana | Medicare Advantage | $50.74 |
| Quartz | Medicare Advantage | $50.74 |
| UHC | Medicare Advantage | $50.74 |
| Anthem | State Specific | $59.37 |
| Anthem | PPO | $59.37 |
| Anthem | HMO/POS | $59.37 |
| UHC | All Payer Appendix | $61.92 |
| Cigna | All Products | $66.31 |
| Group Health of South Central | All Products | $68.80 |
| Trilogy | All Products | $68.80 |
| UCARE | Qualified Health Plan | $68.80 |
| Aspirus Arise Health | All Products | $71.38 |
| Allied National | Core Value Programs | $73.10 |
| Sana | All Products | $73.96 |
Inpatient
$54.52cash price (self-pay)
$86.00list price
$36.38–$81.70range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Quartz | All Other Self Funded | $50.65 |
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All common services at Gundersen TriCounty Hospital and Clinics