CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Loma Linda University Children's Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $22
Cash Discount Price: $113
vs. Medicare Baseline: 2.60x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Loma Linda University Children's Hospital is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $113. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 2.60x the Medicare baseline. Located in 11234 Anderson Street Suite A, Loma Linda, CA.

Cash / Self-Pay

$113

Average discount available for prompt cash payment at this facility.

Insurance Median

$22

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: $113 (1336%)

Insurance Median: $22 (260%)

Cash: $113 (1336% of Medicare)

Ins. Median: $22 (260% 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 260% of the Medicare baseline (a markup of 160%). 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	$7	83%
Alpha Care Medical Group	$8 - $13	95%
Dignity Health	$8 - $13	95%
Epic Health Plan	$8 - $180	95%
Inland Empire Health Plan (Iehp)	$8 - $12	95%
Kaiser Foundation Hospitals	$8 - $300	95%
Upland Medical Group	$8	95%
Vantage Medical Group	$8 - $13	95%
Adventist Health	$10 - $90	118%
Molina Healthcare Of Ca	$11	130%
Lluh Dept Of Risk Management	$12 - $108	142%
Heritage Provider Network	$14	165%
Blue Shield Of California	$22 - $34	260%
Global Benefits Group	$30 - $270	355%
Temecula Valley Physicians Medical Group	$30	355%
Trivalley Medical Group	$30	355%
Cigna	$32 - $37	378%
Aetna	$33	390%
Networks By Design	$33 - $292	390%
Multiplan	$40 - $360	473%
Galaxy Health	$43 - $382	508%
Prime Health Services	$43 - $382	508%
Blue Cross Blue Shield	$84	993%

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 $113.
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 Loma Linda University Children's Hospital 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.