CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Adventist Health Tulare

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $12
Cash Discount Price: $39
vs. Medicare Baseline: 1.42x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Adventist Health Tulare is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 1.42x the Medicare baseline. Located in 869 North Cherry Street, Tulare, CA.

Cash / Self-Pay

$39

Average discount available for prompt cash payment at this facility.

Insurance Median

$12

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: $39 (461%)

Insurance Median: $12 (142%)

Cash: $39 (461% of Medicare)

Ins. Median: $12 (142% 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.

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
Blue Shield Epn	$2 - $274	24%
Blue Cross Blue Shield	$3 - $86	35%
Blue Shield-All Other Plans	$3 - $378	35%
Cigna	$3 - $401	35%
Western Growers - All Plans	$3 - $398	35%
Hs Interplan-All Plans	$5 - $580	59%
Network By Design-All Plans	$5 - $563	59%
UnitedHealthcare	$5 - $627	59%
Multiplan - All Plans	$6 - $736	71%
Ccipa Medi-Cal - All Plans	$7 - $13	83%
Dignity Mcal Op Only	$7 - $11	83%
Healthnet Medi-Cal	$7 - $13	83%
Independence Op Only - All Plans	$7 - $11	83%
Medi-Cal	$7 - $10	83%
Blue Shield Mcare	$8	95%
Dignity Mcr Op Only - All Other Plans	$8	95%
Fhcn Pace Mcr Adv - All Plans	$8	95%
Medicare (plans)	$8	95%
Prime Health - All Plans	$8	95%
Tricare	$8	95%
Cal Forensic Med Grp - All Plans	$11	130%
Prison Hlthcre - All Plans	$11	130%
Bright Health - All Plans	$12	142%
Ah Employee Health Plan - All Plans	$15	177%
Incentive Hlth - All Plans	$15	177%
Healthnet Hmo/Ppo - All Other Plans	$23	272%
Aetna	$73	863%

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 $39.
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 Tulare 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.