CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Northside Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $223
  • Cash Discount Price: $335
  • vs. Medicare Baseline: 26.36x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Northside Hospital is $223. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $335. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 26.36x the Medicare baseline. Located in 1000 Johnson Ferry Road, Ne, Atlanta, GA.
Cash / Self-Pay
$335

Average discount available for prompt cash payment at this facility.

Insurance Median
$223

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: $335 (3960%)
Insurance Median: $223 (2636%)
Cash: $335 (3960% of Medicare)
Ins. Median: $223 (2636% 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 2636% of the Medicare baseline (a markup of 2536%). 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
Fairly Group $7 83%
Aetna $8 - $89 95%
Bccp $8 95%
Blue Cross Blue Shield $8 - $311 95%
Cbww $8 95%
Clear Springs Eon Health $8 95%
Coventry $8 - $303 95%
Humana $8 - $9 95%
Medicare (plans) $8 - $10 95%
UnitedHealthcare $8 - $71 95%
Va Ccn $8 95%
Caresource $9 - $166 106%
Champus Va $9 106%
Clover Health $9 106%
Kaiser $9 - $388 106%
Pruitt Health Premier $9 106%
Tricare $9 106%
Wellcare $9 106%
Ambetter / Centene $10 - $91 118%
Us Dept Of Labor Wc $11 130%
Amerigroup $12 - $72 142%
Medicaid / KanCare $12 - $14 142%
Corvel Workers Comp $13 154%
Employers Choice Network $13 154%
Oscar $13 154%
Streamline Imaging $13 154%
Georgia Workers Compensation $14 165%
Cigna $73 - $281 863%
Northside Health Network $134 1584%
Georgia Reproductive Specialists $178 2104%
Medlien Healthcare Services $178 2104%
Med Care Solutions $201 2376%
Health One Alliance_Ppo $245 2896%
Quick Trip $245 2896%
Novanet_Ppo $312 3688%
Phcs $334 3948%
Beech Steet $379 4480%
Multiplan $379 4480%
Multiplan Workers Comp $379 4480%
Careiq $446 5272%
Dekalb_Department Of Health $446 5272%
Fifa $446 5272%
Institutional Marietta Surgery Center $446 5272%
Institutional Veterans Evaluation Services $446 5272%
Rabun County Boc $446 5272%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Johnson Ferry Road, Ne, Atlanta, GA 30342
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals