CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Community Hospital of Staunton

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $190
Cash Discount Price: $127
vs. Medicare Baseline: 22.46x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Community Hospital of Staunton is $190. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $127. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 22.46x the Medicare baseline. Located in 400 N Caldwell St, Staunton, IL.

Cash / Self-Pay

$127

Average discount available for prompt cash payment at this facility.

Insurance Median

$190

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: $127 (1501%)

Insurance Median: $190 (2246%)

Cash: $127 (1501% of Medicare)

Ins. Median: $190 (2246% 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 2246% of the Medicare baseline (a markup of 2146%). 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
Medicare (plans)	$8 - $76	95%
Tricare	$8 - $73	95%
Clear Spring Health Ma	$9 - $77	106%
Medicaid / KanCare	$15 - $253	177%
UnitedHealthcare	$96 - $253	1135%
Self Pay	$127	1501%
Cigna	$163	1927%
Blue Cross Blue Shield	$190 - $253	2246%
Healthlink	$190 - $215	2246%
Health Alliance Commercial	$203 - $253	2400%
Aetna	$205 - $253	2423%
Multiplan/Phcs	$215	2541%
Beech Street	$230	2719%

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 $127.
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 Community Hospital of Staunton 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.