CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Adventist Health St Helena

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $241
Cash Discount Price: $78
vs. Medicare Baseline: 28.49x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Adventist Health St Helena is $241. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 28.49x the Medicare baseline. Located in 10 Woodland Road, Saint Helena, CA.

Cash / Self-Pay

$78

Average discount available for prompt cash payment at this facility.

Insurance Median

$241

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: $78 (922%)

Insurance Median: $241 (2849%)

Cash: $78 (922% of Medicare)

Ins. Median: $241 (2849% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 2849% of the Medicare baseline (a markup of 2749%). 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 Shield Bh Mcr Adv	$8	95%
Blue Shield Mcr Adv	$8	95%
Kaiser Mcr Adv	$8	95%
Tricare	$8	95%
UnitedHealthcare	$8 - $332	95%
Va Mcr - All Other Plans	$8	95%
Va Medi-Cal	$10	118%
Ah Employee Health Plan - All Plans	$15	177%
Healthnet-All Plans	$44	520%
Aetna	$50	591%
Blue Cross Blue Shield	$73 - $98	863%
Blue Shield Behav Hlth	$234	2766%
Blue Shield Non-Epn	$241	2849%
Blue Shield Epn-All Other Plans	$245	2896%
Western Growers-All Plans	$276	3262%
Phcs-All Plans	$286	3381%
Interplan-All Plans	$338	3995%
Choicecare-All Plans	$364	4303%
Beech Street-All Plans	$390	4610%
Cigna	$416	4917%
Kaiser-All Other Plans	$426	5035%
Health Management Network-All Plans	$442	5225%
Galaxy Network-All Plans	$468	5532%
Three Rivers-All Plans	$468	5532%

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 $78.
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 Adventist Health St Helena 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.