CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: City of Hope National Medical Center

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $158
Cash Discount Price: $225
vs. Medicare Baseline: 18.68x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at City of Hope National Medical Center is $158. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $225. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 18.68x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.

Cash / Self-Pay

$225

Average discount available for prompt cash payment at this facility.

Insurance Median

$158

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: $225 (2660%)

Insurance Median: $158 (1868%)

Cash: $225 (2660% of Medicare)

Ins. Median: $158 (1868% 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 1868% of the Medicare baseline (a markup of 1768%). 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	$6 - $218	71%
Cal Optima	$8 - $10	95%
Heritage Provider Network	$9 - $158	106%
Facey	$11	130%
Inland Empire	$11 - $180	130%
Prime Healthcare Keenan	$15 - $216	177%
UnitedHealthcare	$25 - $126	296%
Healthcare Partners	$29	343%
Blue Cross Blue Shield	$85 - $158	1005%
Blue Shield	$133 - $290	1572%
Blue Shield Covca	$137	1619%
Blue Shield Promise	$158	1868%
Cencal	$180	2128%
La Care Health	$180	2128%
Kaiser	$202	2388%
Aetna	$225	2660%
Gold Coast	$225	2660%
Molina	$225 - $292	2660%
Cigna	$242	2861%
St. Joseph Heritage	$270	3191%
Primecare Medical Network	$292	3452%
First Health	$346	4090%
Phcs Multiplan	$405	4787%

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 $225.
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 City of Hope National Medical Center 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.