CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: UMass Memorial Healthalliance Hospitals

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $14
Cash Discount Price: $90
vs. Medicare Baseline: 1.65x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at UMass Memorial Healthalliance Hospitals is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 1.65x the Medicare baseline. Located in 60 Hospital Road, Leominster, MA.

Cash / Self-Pay

$90

Average discount available for prompt cash payment at this facility.

Insurance Median

$14

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: $90 (1064%)

Insurance Median: $14 (165%)

Cash: $90 (1064% of Medicare)

Ins. Median: $14 (165% 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.

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
Medicaid / KanCare	$7 - $9	83%
Cigna	$8 - $33	95%
Institution [10406]	$8 - $48	95%
Medicare (plans)	$8	95%
Tufts Dual [10111]	$8	95%
Tufts Us Family [11203]	$8	95%
Aetna	$9 - $59	106%
Blue Cross Blue Shield	$9 - $21	106%
Champva [11001]	$9	106%
Commonwealth Care Mcr [10115]	$9	106%
Fallon Mcr Supp [20202]	$9	106%
Grants [20507]	$9 - $90	106%
Harvard Pilgrim Mcr [10106]	$9	106%
Mgb Mcr [10124]	$9	106%
Senior Whole Health [10110]	$9	106%
Tufts Mcr [10112]	$9	106%
UnitedHealthcare	$9 - $90	106%
Correctional Care [11003]	$12 - $13	142%
Workers Compensation [20501]	$12	142%
Tufts Connectorcare [10507]	$14	165%
Tufts [11201]	$19	225%
Harvard Pilgrim [10701]	$22 - $26	260%
Wellpoint [11112]	$22	260%
Hne [11108]	$50	591%
First Health Network [11120]	$68	804%
Multiplan [11109]	$68	804%
Fallon Connectorcare [10503]	$84	993%
Connecticare [11105]	$90	1064%
Fallon Carelon Hlth [28]	$90	1064%
Fallon Mcaid Carelon Hlth [29]	$90	1064%
Hsno/Free Care [10801]	$294	3475%

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 $90.
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 UMass Memorial Healthalliance Hospitals 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.