CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Mt Sinai Hospital Medical Center

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $28
  • Cash Discount Price: $121
  • vs. Medicare Baseline: 3.31x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Mt Sinai Hospital Medical Center is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $121. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 3.31x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.
Cash / Self-Pay
$121

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

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: $121 (1430%)
Insurance Median: $28 (331%)
Cash: $121 (1430% of Medicare)
Ins. Median: $28 (331% 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 331% of the Medicare baseline (a markup of 231%). 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
Advocate Physician Prtnrs Mcr $8 95%
Blue Cross Blue Shield $8 - $189 95%
Cenpatico Illinicare Dual $8 95%
Cenpatico Illinicare Mcr - All Other Plans $8 95%
Cigna $8 - $367 95%
Humana $8 - $932 95%
Lawndale Christian - All Plans $8 - $59 95%
Meridian/Harmony D-Snp - All Plans $8 95%
Nextlevel Hlth Icp Fhp Aca - All Plans $8 95%
Tricare $8 95%
UnitedHealthcare $8 95%
Va Healthnet - All Plans $8 95%
Advocate Physician Prtnrs - All Other Plans $9 106%
Ambetter / Centene $9 - $312 106%
Harmony Behavioral Htlh - All Plans $9 106%
Molina Mcr - All Other Plans $9 106%
Zing Mcr Adv - All Plans $9 106%
Aetna $12 - $671 142%
Family Health Network Mcaid - All Plans $12 142%
Molina Mcaid $13 154%
Partners In Hlth - All Plans $20 - $119 236%
Healthlink Hmo $25 - $148 296%
Healthlink Ppo - All Other Plans $25 - $148 296%
Oscar - All Plans $25 - $54 296%
Compsych Ip/Op Only - All Plans $30 - $178 355%
Hfn Platinum $32 - $193 378%
Multiplan Primary Ntwrk/Phcs - All Other Plans $35 - $208 414%
Hfn Epo $40 - $237 473%
Multiplan Complementary Ntwrk $40 - $237 473%
Hfn Ppo - All Other Plans $43 - $261 508%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15Th Street at California, Chicago, IL 60608
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals