CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Boston Children's Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $104
Cash Discount Price: $146
vs. Medicare Baseline: 12.29x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Boston Children's Hospital is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $146. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 12.29x the Medicare baseline. Located in 300 Longwood Avenue, Boston, MA.

Cash / Self-Pay

$146

Average discount available for prompt cash payment at this facility.

Insurance Median

$104

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: $146 (1726%)

Insurance Median: $104 (1229%)

Cash: $146 (1726% of Medicare)

Ins. Median: $104 (1229% 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 1229% of the Medicare baseline (a markup of 1129%). 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
Blue Cross Blue Shield	$30 - $96	355%
Unicare	$34	402%
Cdphp	$72 - $124	851%
Harvard Pilgrim	$74 - $99	875%
United	$87 - $122	1028%
Aetna	$88 - $122	1040%
Mgb/Allways	$89 - $108	1052%
Tufts Public Plan	$90	1064%
Ambetter / Centene	$92	1087%
United Ri Nj Ny	$92	1087%
Carelon Strategies/Bhs	$95	1123%
UnitedHealthcare	$95 - $124	1123%
Carelon/Beacon	$110	1300%
Fallon	$111 - $113	1312%
Health New England	$118	1395%
Cigna	$124 - $132	1466%
Ets/Lifetrac	$124	1466%
Interlink Transplant	$124	1466%
Community Health Options	$131	1548%
Humana	$131	1548%
Coventry/Hcvm/First Health	$134	1584%
Multiplan/Phcs	$134 - $139	1584%

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 $146.
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 Boston Children's 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.