CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Valley Children's Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $93
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 10.99x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Valley Children's Hospital is $93. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 10.99x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$93

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%)
Insurance Median: $93 (1099%)
Ins. Median: $93 (1099% 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 1099% of the Medicare baseline (a markup of 999%). 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
Allcare Ipa $12 142%
Central California Alliance For Health $16 189%
Dignity Ipa_Formerly Img $17 201%
Kaiser $17 - $120 201%
La Salle Ipa $17 201%
Sante Ipa $17 201%
Central Valley Medical Providers Ipa $18 - $92 213%
Sequoia Health Ipa $18 213%
Univseral Healthcare Ipa $18 213%
Community Care Ipa $19 225%
United Physicians Network Ipa $19 225%
Adventist $21 248%
Blue Cross Blue Shield $22 - $84 260%
Cencal Health $24 284%
Kern Family Health Care $24 284%
Health Net $65 - $121 768%
UnitedHealthcare $75 887%
Dignity Health Central Coast $92 1087%
Community Health $102 1206%
Stanislaus Partners In Health $102 1206%
Physicians Choice Medical Group $104 1229%
Health Plan Of San Joaquin $111 1312%
Fowler Packing $115 1359%
Dignity (Formerly Managed Care Systems) $117 1383%
Kern Legacy $120 1418%
Aetna $124 1466%
Blue Shield $124 - $140 1466%
First Health Formerly Coventry $137 1619%
Bakersfield Family Medical Group $139 1643%
Network By Design $143 1690%
Community Care Health Plan $148 1749%
Health Smart $148 1749%
Key Medical Ipa $148 1749%
Sutter Health $157 1856%
Multiplan $177 2092%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens