CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Scripps Memorial Hospital - Encinitas

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $39
  • Cash Discount Price: $61
  • vs. Medicare Baseline: 4.61x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Scripps Memorial Hospital - Encinitas is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $61. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 4.61x the Medicare baseline. Located in 354 Santa Fe Drive, Encinitas, CA.
Cash / Self-Pay
$61

Average discount available for prompt cash payment at this facility.

Insurance Median
$39

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: $61 (721%)
Insurance Median: $39 (461%)
Cash: $61 (721% of Medicare)
Ins. Median: $39 (461% 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 461% of the Medicare baseline (a markup of 361%). 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
Aetna $8 - $123 95%
Astiva Mcr Adv [464] $8 95%
Bc Mcr Adv [830] $8 95%
Blue Cross Blue Shield $8 - $64 95%
Bs Mcr Adv [829] $8 95%
Central Health Mcr Adv [441] $8 95%
Cigna $8 - $84 95%
Clever Care Mcr Adv [465] $8 95%
D-Snp Mcr Adv [889] $8 95%
Dsnp/Csnp - Generic [458] $8 95%
Family Health Centers Pace Mcr Adv Hmo [556] $8 95%
Family Health Centers Pace Medi-Cal [555] $8 95%
Gary And Mary West Pace Medi-Cal Hmo [557] $8 95%
Gpmg/Altura - Mcr Adv [888] $8 95%
Hn Mcr Adv [832] $8 95%
Humana $8 95%
Integrated Health Partners - Mcr Adv [895] $8 95%
Kaiser Northern Ca Region Mcr Adv [386] $8 95%
La Care Mcr Adv Hmo [612] $8 95%
Medicare (plans) $8 95%
Mpmg Mcr Adv [836] $8 95%
Mpmg [800] $8 95%
Ocn Mcr Adv [890] $8 95%
San Diego Pace Medi-Cal [553] $8 95%
Scan Mcr Adv [835] $8 95%
Scan [500] $8 95%
Scan [818] $8 95%
Sharp Comm Med Grp Mcr Adv [840] $8 95%
Sharp Health Plan Mcr Adv [531] $8 95%
Sharp Health Plan Mcr Adv [897] $8 95%
Sharp Rees Stealy Med Grp Mcr Adv [841] $8 95%
St Paul'S Pace Medi-Cal [551] $8 95%
Ucsd Mcr Adv [873] $8 95%
Uh Mcr Adv [831] $8 95%
Uh Palomar Health Mcr Adv [885] $8 95%
UnitedHealthcare $8 - $85 95%
Alignment Health Plan [443] $9 106%
Health Net [340] $13 - $82 154%
Prime Healthcare [614] $14 165%
Prospect Med Group [893] $15 177%
Radys Cpmg [803] $20 236%
Mc Alignment [917] $37 - $39 437%
Mc Blue Shield Promise Health Plan [914] $37 - $39 437%
Mc Blue Shield [902] $37 - $39 437%
Mc Health Net [904] $37 - $39 437%
Mc Scan [905] $37 - $39 437%
Mc United [906] $37 - $39 437%
Bc [814] $54 638%
Imperial County Phys Med Group [855] $54 - $83 638%
Integrated Health Partners [894] $54 638%
Perlman Med Group [899] $54 638%
Sharp Comm Med Grp [812] $54 - $111 638%
Sharp Rees Stealy Med Grp [811] $54 - $111 638%
Ucsd [807] $54 - $111 638%
Centivo [581] $56 662%
Blue Shield [230] $80 - $87 946%
Hn [815] $82 969%
Bs [816] $83 - $87 981%
Uh [819] $85 1005%
Rady Children'S Hospital [825] $100 1182%
Palomar Health [892] $111 1312%
Veba Med Grp [813] $111 1312%
Kaiser Northern Ca Region Hmo/Ppo [384] $139 1643%
Kaiser [380] $139 1643%
Kaiser [383] $139 1643%
Multi Plan Network [470] $173 2045%
First Health Network [330] $183 2163%
Pnoa [615] $183 2163%
Choice Care Network [270] $195 2305%
Healthsmart [350] $195 2305%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 354 Santa Fe Drive, Encinitas, CA 92024
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals