CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Northwest Health - Porter

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $20
  • Cash Discount Price: $129
  • vs. Medicare Baseline: 2.36x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Northwest Health - Porter is $20. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $129. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 2.36x the Medicare baseline. Located in 85 East Us Hwy 6, Valparaiso, IN.
Cash / Self-Pay
$129

Average discount available for prompt cash payment at this facility.

Insurance Median
$20

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: $129 (1525%)
Insurance Median: $20 (236%)
Cash: $129 (1525% of Medicare)
Ins. Median: $20 (236% 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 236% of the Medicare baseline (a markup of 136%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Blue Cross Blue Shield $3 - $13 35%
UnitedHealthcare $7 - $39 83%
Aetna $8 - $207 95%
Caresource $8 95%
Healthy Indiana Plan $8 95%
Humana $8 95%
Managed Health Services $8 - $17 95%
Medicaid / KanCare $8 95%
Medicare (plans) $8 - $9 95%
Mhs $8 95%
Node Devoted Health Mcr Adv $8 95%
Node Hospice Non Par Agree $8 95%
Node Mhs Mcr Adv $8 95%
Node Va $8 95%
Tricare $8 95%
Veterans Eval Services $8 95%
Care Improvement Plus $9 106%
In Dept Of Correction $9 106%
Node Us Dept Of Labor $11 130%
Align Network $14 165%
One Call Work Comp $14 165%
Encore Health $15 - $326 177%
Prime Health $15 - $306 177%
Indiana Work Comp $17 201%
Lutheran Preferred $17 - $245 201%
Node Encore Kba Epo $20 236%
Porter County $20 236%
Preferred Network Access $20 236%
Magnacare Ma $22 260%
Lutheran Preferred Chs Employees $98 1158%
Self Pay $110 - $147 1300%
Cigna $113 1336%
Physicians Health Plan $156 1844%
Php Freedom $169 1998%
Sagamore Health Network $180 - $242 2128%
First Health Coventry $200 2364%
Encore Ppo $204 2411%
Southeastem Indiana Health Operations $286 - $306 3381%
Network Synergy Group $306 3617%
Multiplan/Phcs $343 4054%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 85 East Us Hwy 6, Valparaiso, IN 46383
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals