CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Nemours Childrens Hospital, Florida

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $167
Cash Discount Price: $407
vs. Medicare Baseline: 19.74x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Nemours Childrens Hospital, Florida is $167. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $407. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 19.74x the Medicare baseline. Located in 6535 Nemours Pkwy, Orlando, FL.

Cash / Self-Pay

$407

Average discount available for prompt cash payment at this facility.

Insurance Median

$167

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: $407 (4811%)

Insurance Median: $167 (1974%)

Cash: $407 (4811% of Medicare)

Ins. Median: $167 (1974% 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 1974% of the Medicare baseline (a markup of 1874%). 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
Tricare	$8	95%
UnitedHealthcare	$8	95%
Cigna	$11 - $164	130%
Truli	$43 - $163	508%
Florida Blue	$48 - $248	567%
Avmed	$126	1489%
Employers Health Network Fl	$163	1927%
Aetna	$179	2116%
Evolutions Healthcare	$183	2163%
Integra Administrative Group	$244	2884%
Global Medical Management	$265	3132%
Prime Health Services	$265	3132%
Star Healthcare Network	$265	3132%
Velocity	$305	3605%
First Health Network	$317	3747%
Pnoa	$326	3853%
Seminole Tribe Of Fl	$326	3853%
Private Healthcare Systems	$374	4421%

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 $407.
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 Nemours Childrens Hospital, Florida 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.