CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Adventist Health and Rideout

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $49
Cash Discount Price: $24
vs. Medicare Baseline: 5.79x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Adventist Health and Rideout is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $24. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 5.79x the Medicare baseline. Located in 726 4Th St, Marysville, CA.

Cash / Self-Pay

$24

Average discount available for prompt cash payment at this facility.

Insurance Median

$49

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: $24 (284%)

Insurance Median: $49 (579%)

Cash: $24 (284% of Medicare)

Ins. Median: $49 (579% 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 579% of the Medicare baseline (a markup of 479%). 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
Bc Mcal	$2	24%
Healthnet Mcal	$8 - $77	95%
Kaiser Mcr Adv	$8	95%
Tricare	$8	95%
UnitedHealthcare	$8 - $333	95%
Blue Cross Blue Shield	$9 - $295	106%
Kaiser Mcal	$10	118%
Medi-Cal	$10	118%
Partnership Hp Mcal -All Plans	$10	118%
Ca Health And Wellness- All Plans	$12	142%
Celtic Mcaid-All Plans	$12	142%
Ah Employee Health Plan - All Plans	$15	177%
Healthnet Comm-All Other Plans	$23 - $229	272%
Aetna	$27 - $271	319%
Kaiser-All Other Plans	$29 - $291	343%
Blue Shield Uc Care Members	$30 - $306	355%
Cigna	$32 - $326	378%
First Health-All Plans	$33 - $335	390%
Phcs-All Plans	$33 - $337	390%
Interplan-All Plans	$34 - $345	402%
Blue Shield-All Other Plans	$36 - $364	426%
Multiplan-All Plans	$36 - $364	426%

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 $24.
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 and Rideout 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.