CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Decatur Memorial Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $80
Cash Discount Price: $147
vs. Medicare Baseline: 9.46x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Decatur Memorial Hospital is $80. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $147. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 9.46x the Medicare baseline. Located in 2300 North Edward Street, Decatur, IL.

Cash / Self-Pay

$147

Average discount available for prompt cash payment at this facility.

Insurance Median

$80

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: $147 (1738%)

Insurance Median: $80 (946%)

Cash: $147 (1738% of Medicare)

Ins. Median: $80 (946% 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 946% of the Medicare baseline (a markup of 846%). 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
Aetna	$8 - $99	95%
Blue Cross Blue Shield	$8 - $147	95%
Coventry	$8 - $75	95%
Health Alliance	$8 - $98	95%
Humana	$8 - $96	95%
Medicare (plans)	$8	95%
Tricare	$8	95%
UnitedHealthcare	$8 - $147	95%
Veterans Administration	$8	95%
Wellcare	$8	95%
Medicaid / KanCare	$9	106%
Caterpillar	$11	130%
Plain Church Medical Group	$11 - $66	130%
Illinois Workers Compensation	$46 - $96	544%
Mennonite Churches	$51	603%
Cigna	$68	804%
Health Alliance Mh Employee Plan	$68	804%
6 Degrees Health	$88	1040%
Hopetrust	$88	1040%
Hst	$88	1040%
Hfn	$90 - $110	1064%
Commercial Workers Compensation	$91	1076%
Phcs Savility	$96	1135%
Phcs Multiplan Ppo	$100	1182%
Healthlink	$101	1194%
Corvel	$106	1253%
Consociate	$109	1288%
Liability	$147	1738%

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 $147.
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 Decatur Memorial Hospital 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.