CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Saint Joseph Regional Medical Center

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $284
  • Cash Discount Price: $1,319
  • vs. Medicare Baseline: 33.57x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Saint Joseph Regional Medical Center is $284. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,319. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 33.57x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$1,319

Average discount available for prompt cash payment at this facility.

Insurance Median
$284

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: $1,319 (15591%)
Insurance Median: $284 (3357%)
Cash: $1,319 (15591% of Medicare)
Ins. Median: $284 (3357% 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 3357% of the Medicare baseline (a markup of 3257%). 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
Aetna $5 - $1,487 59%
Blue Cross Blue Shield $5 - $3,388 59%
Medicaid / KanCare $5 - $1,284 59%
UnitedHealthcare $5 - $1,284 59%
Managed Health Services - Indiana $8 - $1,284 95%
Mdwise $8 - $1,284 95%
Medicare (plans) $8 - $979 95%
Meridian Complete $8 - $960 95%
Pace-Trinity Health $8 - $960 95%
County Coroner $9 - $998 106%
Provider Partners Health Plan Of Indiana $9 - $1,056 106%
Auxiant $13 - $2,063 154%
Caresource $13 - $1,487 154%
Physicians Health Plan Northern Indiana Health Insurance $13 - $2,898 154%
St Joseph County Hlth Dpt $13 - $1,439 154%
Siho Insurance Services $14 - $1,535 165%
Key Benefit Administrator $15 - $2,063 177%
Allied Benefit Systems $16 - $1,823 189%
Blue Benefit Administrators Of Massachusetts $17 - $3,388 201%
Blue Care Network $17 - $3,388 201%
Blue Distinction Transplant $17 - $3,388 201%
Blue Shield - Ca $17 - $3,388 201%
Blue Shield - Id (Regence) $17 - $3,388 201%
Blue Shield - Ny Highmark Northeastern $17 - $3,388 201%
Blue Shield - Ny Highmark Western $17 - $3,388 201%
Blue Shield - Pa (Highmark) $17 - $3,388 201%
Blue Shield - Wa (Regence) $17 - $3,388 201%
Custom Design Benefits $18 - $2,063 213%
Hospice Of Marshall County $116 1371%
Hospice Of St Joseph County $116 1371%
Plain Church Group $120 1418%
Asr Health Benefits $218 2577%
Christian Brother Services $218 2577%
Employee Benefit Management $218 2577%
Medical Mutual $218 2577%
Meritain $218 2577%
Preferred One $218 2577%
Rural Carrier Health Benefit Plan $218 2577%
Webtpa $218 2577%
Notre Dame Athletic Association $245 2896%
Wc Notre Dame $245 2896%
Luminare Health (Detroit) $254 - $268 3002%
Encore Health $264 - $278 3121%
Ameriben $268 3168%
Indiana Criminal Justice Inst $278 3286%
Western & Southern Financial Group $278 3286%
Geha $284 3357%
Healthscope $284 3357%
Student Insurance Cma $284 3357%
Cigna $285 3369%
Group Administrators $285 3369%
Health Partners $285 3369%
Mvp $285 3369%
Prairie States $285 3369%
Priority Health $285 3369%
Professional Benefit Administrators $285 3369%
Sagamore Health Network $285 - $330 3369%
Sisco Benefits $285 3369%
Unified Group Services $285 3369%
Goshen Preferred Network $343 - $384 4054%
Christian Brothers Holy Cross $357 4220%
Signature Care $357 4220%
Bankers Life Casualty $446 5272%
Bureau Of Disability $446 5272%
Wc Align Network $446 5272%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5215 Holy Cross Pkwy, Mishawaka, IN 46545
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals