CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Sonoma Valley Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $98
  • Cash Discount Price: $314
  • vs. Medicare Baseline: 11.58x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Sonoma Valley Hospital is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $314. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 11.58x the Medicare baseline. Located in 347 Andrieux St, Sonoma, CA.
Cash / Self-Pay
$314

Average discount available for prompt cash payment at this facility.

Insurance Median
$98

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: $314 (3712%)
Insurance Median: $98 (1158%)
Cash: $314 (3712% of Medicare)
Ins. Median: $98 (1158% 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 1158% of the Medicare baseline (a markup of 1058%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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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 Cross Blue Shield $8 - $449 95%
Bright Hlth/Brand New Day Mcr Adv $8 95%
Hospice Of Marin-All Plans $8 95%
St Joseph Heritage Hltcare Comm-All Other Plans $8 95%
Tricare $8 95%
Veterans Admin-All Plans $8 95%
Marin General Comm/Mcr Adv (Western Hlth)-All Plan $9 106%
Cdcr Prison-All Plans $10 118%
Medi-Cal $10 118%
Partnership Healthplan-All Plans $10 118%
Three Rivers (Trpn)-All Plans $10 118%
Bright Hlth/Brand New Day - All Other Plands $11 130%
Chp - Correctional Health Partners - All Plans $11 130%
Wellpath - All Plans $12 142%
Aetna $14 165%
First Health(Coventry)-All Plans $14 165%
Canopy Bay Area Accountable Care Ntwrk (Baacn) - A $15 177%
Canopy Health Solutions-All Other Plans $15 177%
Mcal Mgd Care (Php)-All Plans $16 189%
UnitedHealthcare $17 201%
Meritage Medical Network Op Only Mcare $38 449%
Meritage Medical Network Op Only-All Other Plans $38 449%
Healthnet Hmo/Ppo-All Other Plans $157 1856%
Blue Shield Ppo-All Plans $255 3014%
Kaiser-All Plans $292 3452%
Integrated Health Plan-All Plans $332 3924%
Champus-All Plans $359 4243%
Cigna $359 4243%
Networks By Design - All Plans $359 4243%
Comm Care Network(Ccn)-All Plans $382 4515%
Great West-One Health Plan Ppo/Pos-All Plans $382 4515%
Phcs/Multiplan/Beech St-All Plans $382 4515%
Interplan-All Plans $395 4669%
Bps-All Plans $404 4775%
Ppo Alliance-All Plans $404 4775%
Pref Health Networl(Phn)-All Plans $404 4775%
Scan Mcare-All Plans $449 5307%
St Joseph Heritage Hltcare Mcr Adv $449 5307%
Correct Care Integ Health-All Plans $539 6371%
Employer Direct Healthcare-All Plans $539 6371%
Creative Legal Services-All Plans $584 6903%
Canopy Op Only $808 9551%
Vnpn - All Plans $808 9551%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 347 Andrieux St, Sonoma, CA 95476
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals