CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Nemours Children's Hospital, Delaware

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $176
  • Cash Discount Price: $314
  • vs. Medicare Baseline: 20.80x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Nemours Children's Hospital, Delaware is $176. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $314. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 20.80x the Medicare baseline. Located in 1600 Rockland Rd Po Box 269, Wilmington, DE.
Cash / Self-Pay
$314

Average discount available for prompt cash payment at this facility.

Insurance Median
$176

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: $314 (3712%)
Insurance Median: $176 (2080%)
Cash: $314 (3712% of Medicare)
Ins. Median: $176 (2080% 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 2080% of the Medicare baseline (a markup of 1980%). 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
Priority Partners John Hopkins $8 - $154 95%
Tricare $9 106%
Us Family Health Plan $10 118%
Celtic Transplant $15 - $314 177%
Keystone First Hlth Plan $63 - $139 745%
Amerihealth Caritas Delaware $96 - $179 1135%
Blue Cross Blue Shield $97 - $277 1147%
Celtic Transplant For De First Health $110 1300%
Delaware First Health $113 1336%
UnitedHealthcare $115 - $196 1359%
Wellpoint Maryland $116 1371%
Kidz Partners $119 1407%
Health Partners $122 1442%
Upmc $124 1466%
Fidelis $126 1489%
Aetna $133 - $182 1572%
Six Degrees Health Transplant $157 1856%
Cigna $173 - $198 2045%
Great West-One Health Plan $173 - $198 2045%
Ambetter / Centene $179 2116%
Geisinger Health Plan $188 2222%
Integra Administrative Group $188 2222%
National Transplant Network (Ntn) $204 2411%
Six Degrees Health $204 2411%
Star Healthcare Network $204 2411%
Life Trac Solid Organ And Bmt Transplant $220 2600%
First Health Network $298 3522%
Insurance Administrators Of America $298 3522%
Interlink Transplant Network $298 3522%
Multiplan $298 3522%
Preferred Healthcare $298 3522%
Private Healthcare Systems $298 3522%
Three Rivers Provider Network $298 3522%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Rockland Rd Po Box 269, Wilmington, DE 19899
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens