CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Grossmont Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $199
Cash Discount Price: $264
vs. Medicare Baseline: 23.52x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Grossmont Hospital is $199. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $264. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 23.52x the Medicare baseline. Located in 5555 Grossmont Center Drive Box 58, La Mesa, CA.

Cash / Self-Pay

$264

Average discount available for prompt cash payment at this facility.

Insurance Median

$199

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: $264 (3121%)

Insurance Median: $199 (2352%)

Cash: $264 (3121% of Medicare)

Ins. Median: $199 (2352% 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 2352% of the Medicare baseline (a markup of 2252%). 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
Health Net	$1 - $282	12%
Medi-Cal	$1 - $246	12%
Blue Cross Blue Shield	$4 - $675	47%
Kaiser	$19	225%
Aetna	$105 - $264	1241%
Epic Americas	$105	1241%
Cigna	$106 - $196	1253%
Medicare (plans)	$120	1418%
Multiplan	$120 - $282	1418%
Blue Shield	$138 - $236	1631%
Interplan	$139	1643%
Humana	$196	2317%
UnitedHealthcare	$211 - $271	2494%
Allianz Global Assistance	$236	2790%
Community Health Group	$236 - $243	2790%
Managed Health Network	$246	2908%
Molina	$246	2908%
Indian Health Council	$289	3416%

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 $264.
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 Grossmont 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.