CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Advocate Sherman Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $69
  • Cash Discount Price: $69
  • vs. Medicare Baseline: 8.16x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Advocate Sherman Hospital is $69. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 8.16x the Medicare baseline. Located in 1425 North Randall Road, Elgin, IL.
Cash / Self-Pay
$69

Average discount available for prompt cash payment at this facility.

Insurance Median
$69

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: $69 (816%)
Insurance Median: $69 (816%)
Cash: $69 (816% of Medicare)
Ins. Median: $69 (816% 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 816% of the Medicare baseline (a markup of 716%). 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
UnitedHealthcare $8 95%
Ambetter / Centene $12 142%
Molina $12 142%
Oscar Health Hmo $13 154%
Hstechnology $16 189%
Cigna $39 461%
Aetna $46 544%
Advocate Employee $47 - $68 556%
Blue Cross Blue Shield $69 - $90 816%
Private Healthcare Systems $97 - $126 1147%
Multiplan $108 - $140 1277%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1425 North Randall Road, Elgin, IL 60123
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals