CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Idaho Falls Community Hospital, LLC

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $8
Cash Discount Price: $42
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Idaho Falls Community Hospital, LLC is $8. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 0.95x the Medicare baseline. Located in 2327 Coronado St, Idaho Falls, ID.

Cash / Self-Pay

$42

Average discount available for prompt cash payment at this facility.

Insurance Median

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: $42 (496%)

Insurance Median: $8 (95%)

Cash: $42 (496% of Medicare)

Ins. Median: $8 (95% 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
Aetna	$8	95%
Anasazi Medical Payment Solutions	$8	95%
Blue Cross Blue Shield	$8 - $20	95%
Humana	$8	95%
Molina Healthcare	$8	95%
Mount Carmel Health Plan	$8	95%
Pacificsource	$8	95%
Regence Blue Shield Of Id Community Care	$8	95%
Selecthealth	$8	95%
UnitedHealthcare	$8	95%
Moda	$19	225%
Mountain Health Co-Op	$23	272%

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 $42.
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 Idaho Falls Community Hospital, LLC 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.