CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Unity Physicians Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $11,325
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1338.65x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Unity Physicians Hospital is $11,325. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 1338.65x the Medicare baseline. Located in 4455 Edison Lakes Pkwy, Mishawaka, IN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$11,325

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%)
Insurance Median: $11,325 (133865%)
Ins. Median: $11,325 (133865% 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 133865% of the Medicare baseline (a markup of 133765%). 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
Blue Cross Blue Shield $8 - $17,574 95%
Medicaid / KanCare $8 95%
Mhs Hoosier Care Connect $8 95%
Nalc $100 - $23,749 1182%
Sagamore Health Network $100 - $23,749 1182%
Multiplan $109 1288%
Multiplan Wc $134 1584%
Aarp Supplemental $11,325 133865%
Aetna $11,325 133865%
Cigna $11,325 133865%
Department Of Va $11,325 133865%
Medicare (plans) $11,325 133865%
Mhs Healthy Indiana Plan $11,325 133865%
Railroad Retirement $11,325 133865%
UnitedHealthcare $11,325 - $23,749 133865%
Three Rivers Provider Network $13,590 160638%
Encore $20,386 240969%
Humana $21,000 248227%
Provider Network Of America $22,651 267742%
All Savers $23,749 280721%
Medica $23,749 280721%
Medica Ifb $23,749 280721%
Oxford $23,749 280721%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4455 Edison Lakes Pkwy, Mishawaka, IN 46545
  • CMS Rating: No CMS Rating
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals