CMS Price Transparency Data
Blood test, basic metabolic panel
Facility: St Joe Mercy Hospital System Livonia
Billing Code: 80048 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80048
- Insurance Median: $66
- Cash Discount Price: $68
- vs. Medicare Baseline: 7.80x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at St Joe Mercy Hospital System Livonia is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $68. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 7.80x the Medicare baseline. Located in 36475 Five Mile Road, Livonia, MI.
Cash / Self-Pay
$68
Average discount available for prompt cash payment at this facility.
Insurance Median
$66
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: $68 (804%)
Insurance Median: $66 (780%)
Cash: $68 (804% of Medicare)
Ins. Median: $66 (780% 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 780% of the Medicare baseline (a markup of 680%). 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 | $5 - $11 | 59% |
| Medicaid / KanCare | $5 | 59% |
| Aetna | $8 - $46 | 95% |
| Align Senior Care | $8 | 95% |
| Angela Hospice | $8 | 95% |
| Blue Care Network Advantage | $8 | 95% |
| Hospice Of Michigan | $8 | 95% |
| Medicare (plans) | $8 - $9 | 95% |
| Cca - Zing Health | $9 | 106% |
| UnitedHealthcare | $9 - $67 | 106% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $10 | 118% |
| Bcn Domestic | $11 | 130% |
| Blue Benefit Administrators Of Massachusetts | $11 | 130% |
| Blue Care Network | $11 | 130% |
| Blue Distinction Transplant | $11 | 130% |
| Blue Shield - Ca | $11 | 130% |
| Blue Shield - Id (Regence) | $11 | 130% |
| Blue Shield - Ny Highmark Northeastern | $11 | 130% |
| Blue Shield - Ny Highmark Western | $11 | 130% |
| Blue Shield - Pa (Highmark) | $11 | 130% |
| Blue Shield - Wa (Regence) | $11 | 130% |
| Health Choices | $11 - $67 | 130% |
| Kaiser Domestic | $11 | 130% |
| Molina Marketplace | $11 | 130% |
| Geha | $13 - $67 | 154% |
| Health Cost Solutions | $13 | 154% |
| Luminare Health (Detroit) | $13 | 154% |
| Meritain | $13 | 154% |
| Vitalcore | $13 | 154% |
| Wellpath | $13 | 154% |
| U Of M Health Plan | $14 | 165% |
| Employee Benefit Logistic | $19 | 225% |
| Priority Health | $20 - $22 | 236% |
| Wc Accident Fund | $30 | 355% |
| Wc Advantage | $30 | 355% |
| Wc Aig | $30 | 355% |
| Wc Allied | $30 | 355% |
| Wc Amerisure | $30 | 355% |
| Wc Amtrust | $30 | 355% |
| Wc Asu Risk Mgt | $30 | 355% |
| Wc Berkley Admin | $30 | 355% |
| Wc Broadspire | $30 | 355% |
| Wc Bunch & Associates | $30 | 355% |
| Wc Ccmsi | $30 | 355% |
| Wc Emc Insurance Company | $30 | 355% |
| Wc Esis | $30 | 355% |
| Wc Fcci | $30 | 355% |
| Wc Federated | $30 | 355% |
| Wc Gallagher Bassett | $30 | 355% |
| Wc Genex Care For Ohio | $30 | 355% |
| Wc Guard Insurance Company | $30 | 355% |
| Wc Hartford | $30 | 355% |
| Wc Liberty Mutual | $30 | 355% |
| Wc Meijers | $30 | 355% |
| Wc Michigan | $30 | 355% |
| Wc Mitchell Frankenmuth | $30 | 355% |
| Wc Pma | $30 | 355% |
| Wc Sedgwick | $30 | 355% |
| Wc Sentry | $30 | 355% |
| Wc Travelers | $30 | 355% |
| Wc Tristar | $30 | 355% |
| Wc Walmart | $30 | 355% |
| Wc Zurich | $30 | 355% |
| Asr Health Benefits | $33 | 390% |
| Caresource | $33 | 390% |
| Hap | $33 - $64 | 390% |
| Varipro | $33 | 390% |
| Acs Benefit Services | $45 | 532% |
| Allied Benefit Systems | $45 | 532% |
| Claimchoice Adminstrators | $45 | 532% |
| Consociate | $45 | 532% |
| Cypress Benefit Administrators | $45 | 532% |
| Forest County Potawatomi | $45 | 532% |
| Health Smart | $45 | 532% |
| Healthgram | $45 | 532% |
| Healthscope | $45 | 532% |
| Secureone Preferred United Plans | $45 | 532% |
| Sisco Benefits | $45 | 532% |
| The Health Plan | $45 | 532% |
| Trustmark Small Business Benefits | $45 | 532% |
| Unified Group Services | $45 | 532% |
| Webtpa | $45 | 532% |
| Health Partners | $64 | 757% |
| Tufts Health Plan | $64 | 757% |
| Cigna | $66 - $84 | 780% |
| 1199 National Benefit Fund | $67 | 792% |
| Access Health | $67 | 792% |
| Acclaim | $67 | 792% |
| Administrative Concepts | $67 | 792% |
| Allegeant | $67 | 792% |
| Allied National Global Care | $67 | 792% |
| Ameriben | $67 | 792% |
| American Family | $67 | 792% |
| American Healthcare Alliance | $67 | 792% |
| American National | $67 | 792% |
| American Republic | $67 | 792% |
| Amerihealth | $67 | 792% |
| Asrm - Reliance Standard Life Insurance | $67 | 792% |
| Aultcare | $67 | 792% |
| Automated Benefit Services | $67 | 792% |
| Auxiant | $67 | 792% |
| Benefit Administrative Systems,Llc | $67 | 792% |
| Boon Chapman | $67 | 792% |
| Cam Administrative Services | $67 | 792% |
| Christian Brother Services | $67 | 792% |
| Christian Brothers Holy Cross | $67 | 792% |
| Christian Care Ministry | $67 | 792% |
| Comprehensive Benefits | $67 | 792% |
| Continental Life Insurance | $67 | 792% |
| Custom Benefit Administrators | $67 | 792% |
| Dean Health | $67 | 792% |
| Employee Benefit Concepts | $67 | 792% |
| Employee Benefit Management | $67 | 792% |
| Enterprise Group Planning | $67 | 792% |
| Fallon Health | $67 | 792% |
| Family Life Insurance Company | $67 | 792% |
| Freedom Life Insurance Company | $67 | 792% |
| Ghc Scw | $67 | 792% |
| Group Administrators | $67 | 792% |
| Group Marketing Services | $67 | 792% |
| Group Pension Administrators | $67 | 792% |
| Guardian | $67 | 792% |
| Health America | $67 | 792% |
| Healthcare Management Admin | $67 | 792% |
| Healthez | $67 | 792% |
| Humana | $67 | 792% |
| Insight | $67 | 792% |
| Intercare | $67 | 792% |
| International Benefit Administrators | $67 | 792% |
| Jfp Benefit Management | $67 | 792% |
| Jp Farley Corporation | $67 | 792% |
| Key Benefit Administrator | $67 | 792% |
| Liberty Union Life Assurance Co | $67 | 792% |
| Lifetime Benefit Solutions | $67 | 792% |
| Lucent Health | $67 | 792% |
| Luminare Health | $67 | 792% |
| Magnacare | $67 | 792% |
| Manhattan Life | $67 | 792% |
| Medben | $67 | 792% |
| Medcost | $67 | 792% |
| Medi Share | $67 | 792% |
| Medical Mutual | $67 | 792% |
| Multiplan | $67 | 792% |
| Mutual Health Services | $67 | 792% |
| Mutual Of Omaha | $67 | 792% |
| Mvp | $67 | 792% |
| Ncas | $67 | 792% |
| Nippon Life Ins | $67 | 792% |
| Nova | $67 | 792% |
| Pai | $67 | 792% |
| Painters Union Insurance Fund | $67 | 792% |
| Pan-American Life | $67 | 792% |
| Paramount Hmo | $67 | 792% |
| Phcs | $67 | 792% |
| Physicians Mutual | $67 | 792% |
| Plumbers Local 98 Insurance Fund | $67 | 792% |
| Prairie States | $67 | 792% |
| Preferred One | $67 | 792% |
| Primary Physician Care | $67 | 792% |
| Professional Benefit Administrators | $67 | 792% |
| Siho Insurance Services | $67 | 792% |
| The Loomis Company | $67 | 792% |
| Trinity Health Share | $67 | 792% |
| Unicare | $67 | 792% |
| Us Health And Life | $67 | 792% |
| Valenz | $67 | 792% |
| Western & Southern Financial Group | $67 | 792% |
| Wps | $67 | 792% |
| First Health | $69 | 816% |
| Coventry | $84 | 993% |
| Prime Health Services | $84 | 993% |
| Three Rivers Provider Network | $94 | 1111% |
| Carelon Behavioral Health | $105 | 1241% |
| Cmh Detroit Wayne Integrated Health Network | $105 | 1241% |
| Cmh Lenawee County | $105 | 1241% |
| Cmh Livingston County | $105 | 1241% |
| Cmh Misc | $105 | 1241% |
| Cmh Monroe County | $105 | 1241% |
| Cmh Washtenaw County | $105 | 1241% |
| Magellan Behavioral Health | $105 | 1241% |