CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Adventist Health Sierra Vista

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $310
Cash Discount Price: $146
vs. Medicare Baseline: 36.64x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Adventist Health Sierra Vista is $310. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $146. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 36.64x the Medicare baseline. Located in 1010 Murray St, San Luis Obispo, CA.

Cash / Self-Pay

$146

Average discount available for prompt cash payment at this facility.

Insurance Median

$310

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: $146 (1726%)

Insurance Median: $310 (3664%)

Cash: $146 (1726% of Medicare)

Ins. Median: $310 (3664% 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 3664% of the Medicare baseline (a markup of 3564%). 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
UnitedHealthcare	$6 - $559	71%
Aetna	$8	95%
Cencal Mcr Adv - All Other Plans	$8	95%
Tricare	$8	95%
Blue Shield Epo/Ppo-All Other Plans	$10	118%
Cfmg-Ca Forensic Med Grp Op/Profee Only-All Plans	$11	130%
Ah Employee Health Plan - All Plans	$15	177%
Nbd-Ntwrks By Design Non-Exclus	$34	402%
Cencal Mcal	$67	792%
Hpn-Heritage Prov Ntwrk-All Plans	$552	6525%
Blue Shield Epn	$637	7530%
Blue Shield Hmo/Pos	$793	9374%
Nbd-Ntwrks By Design Exclus-All Other Plans	$938	11087%
Medi-Cal	$1,625	19208%
Blue Shield Promise Mcal	$1,953	23085%
Ccah-Centrl Ca Allince Mcal-All Plans	$2,112	24965%
Coalinga-All Plans	$2,112	24965%

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 $146.
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 Sierra Vista 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.