CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: John Muir Medical Center - Walnut Creek Campus

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $114
  • Cash Discount Price: $432
  • vs. Medicare Baseline: 13.48x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at John Muir Medical Center - Walnut Creek Campus is $114. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $432. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 13.48x the Medicare baseline. Located in 1601 Ygnacio Valley Rd, Walnut Creek, CA.
Cash / Self-Pay
$432

Average discount available for prompt cash payment at this facility.

Insurance Median
$114

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: $432 (5106%)
Insurance Median: $114 (1348%)
Cash: $432 (5106% of Medicare)
Ins. Median: $114 (1348% 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 1348% of the Medicare baseline (a markup of 1248%). 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.

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
Contra Costa County Jail [1012104] $7 83%
Aetna $8 - $694 95%
Alignment Health [1177113] $8 95%
Blue Cross Blue Shield $8 - $624 95%
Blue Shield-Network Mcare [1006127] $8 95%
Care 1St Health Plan [1094113] $8 95%
Caremore [1171113] $8 95%
Covid19 Hrsa Uninsured Testing And Treatment Fund [1179012] $8 95%
Easy Choice Health Plan [1083113] $8 95%
Essence Healthcare [1049028] $8 95%
Essence Healthcare [1049128] $8 95%
Golden State-Network Mcare [1023127] $8 95%
Health Net-Network Mcare [1028127] $8 95%
Hospice Of East Bay [1085104] $8 95%
Humana $8 - $797 95%
Medicare (plans) $8 - $768 95%
Scan-Network Mcare [1043127] $8 95%
UnitedHealthcare $8 - $562 95%
Veterans Administration [1051113] $8 95%
Jmpn Canopy Hn [1640000011] $10 118%
Generic Commercial/Indemnity [1017001] $11 - $384 130%
Generic Hmo [1018103] $11 130%
Generic Ppo [1021104] $11 130%
Canopy Hn Hmo [1166103] $15 177%
Brms [1091104] $114 1348%
Delta Health Systems [1032104] $114 1348%
Empire Plan [1092104] $114 1348%
Healthcomp [1089104] $114 - $816 1348%
Carecentrix [1011001] $384 4539%
Aps Healthcare [1003103] $432 5106%
United Behavioral Health [1048103] $483 5709%
Cigna $488 - $688 5768%
Carelon Behavioral Health [1050104] $528 6241%
Fortified Provider Network [1063104] $528 6241%
Medigap [1036001] $528 6241%
Three Rivers Provider Network [1073104] $528 6241%
Health Net Hmo [1028103] $548 6478%
Health Net-Network [1028026] $548 6478%
Contra Costa Health Plan Hmo [1013103] $576 6809%
Blue Shield Hmo [1006103] $595 - $610 7033%
Blue Shield-Network [1006026] $595 - $610 7033%
Blue Shield Ppo [1006104] $639 - $707 7553%
Western Health Advantage Hmo [1053103] $672 - $768 7943%
Health Net Ppo [1028104] $698 8251%
Federal Correction Institute [1062104] $768 9078%
First Health [1016104] $768 - $816 9078%
Healthsmart - Pka Interplan [1031104] $768 9078%
National Provider Network/Plancare America [1069104] $768 9078%
Networks By Design [1084104] $768 9078%
Pponext [1072104] $768 9078%
Sutter Preferred Health Plan [1044104] $768 9078%
Kaiser Hmo [1033103] $778 9196%
Health Management Network [1066104] $816 9645%
Galaxy Health Network [1064104] $864 10213%
Integrated Health Plan [1075104] $864 10213%
Donor Network West [1008103] $4,000 - $8,000 47281%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1601 Ygnacio Valley Rd, Walnut Creek, CA 94598
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals