CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Elkhart General Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $47
Cash Discount Price: $51
vs. Medicare Baseline: 5.56x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Elkhart General Hospital is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $51. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 5.56x the Medicare baseline. Located in 600 E Blvd, Elkhart, IN.

Cash / Self-Pay

$51

Average discount available for prompt cash payment at this facility.

Insurance Median

$47

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: $51 (603%)

Insurance Median: $47 (556%)

Cash: $51 (603% of Medicare)

Ins. Median: $47 (556% 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 556% of the Medicare baseline (a markup of 456%). 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
Mclaren (Mi	$5	59%
UnitedHealthcare	$5 - $52	59%
Blue Cross Blue Shield	$7 - $19	83%
Aetna	$8 - $53	95%
Caresource	$8 - $101	95%
Humana	$8 - $55	95%
Mdwise	$8 - $101	95%
Mhs	$8 - $101	95%
Pace	$8	95%
Devoted Healthcare	$9 - $16	106%
Plain Church	$13 - $62	154%
Cha	$47 - $61	556%
Immergrun	$47 - $62	556%
Php	$51 - $55	603%
Cigna	$56 - $59	662%
Multiplan	$56	662%
Signature	$57	674%
Encore	$58	686%
Heartland	$78	922%

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 $51.
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 Elkhart General 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.