CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: St Rose Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $13
Cash Discount Price: $91
vs. Medicare Baseline: 1.54x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at St Rose Hospital is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $91. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 1.54x the Medicare baseline. Located in 27200 Calaroga Ave, Hayward, CA.

Cash / Self-Pay

$91

Average discount available for prompt cash payment at this facility.

Insurance Median

$13

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$8.46

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.46 (100%)

Cash / Self-Pay: $91 (1076%)

Insurance Median: $13 (154%)

Cash: $91 (1076% of Medicare)

Ins. Median: $13 (154% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.46 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.

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
Aetna	$8 - $152	95%
Brown & Toland	$8	95%
Centers For Elder Independence	$8	95%
Healthnet Of California	$8 - $212	95%
Humana	$8	95%
Imperial Health Senior	$8	95%
Medicare (plans)	$8	95%
UnitedHealthcare	$8 - $243	95%
Cigna	$11 - $228	130%
Canopy	$16	189%
Blue Shield	$21	248%
Blue Shield Affinity	$21	248%
Blue Shield Hill	$21	248%
Blue Cross Blue Shield	$24	284%
Interplan	$212	2506%
Multiplan Inc	$234	2766%
Kaiser Foundation Hospitals	$243	2872%
Preferred Health Network	$258	3050%

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 $91.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80048.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St Rose Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 80048.
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.