CMS Price Transparency Data
Blood test, basic metabolic panel
Facility: Trinity Health Oakland Hospital
Billing Code: 80048 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80048
- Insurance Median: $71
- Cash Discount Price: $68
- vs. Medicare Baseline: 8.39x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Trinity Health Oakland Hospital is $71. 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 8.39x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.
Cash / Self-Pay
$68
Average discount available for prompt cash payment at this facility.
Insurance Median
$71
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: $71 (839%)
Cash: $68 (804% of Medicare)
Ins. Median: $71 (839% 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 839% of the Medicare baseline (a markup of 739%). 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 - $12 | 59% |
| Medicaid / KanCare | $5 | 59% |
| Aetna | $8 - $48 | 95% |
| Align Senior Care | $8 | 95% |
| Blue Care Network Advantage | $8 | 95% |
| Hospice Advantage | $8 | 95% |
| Medicare (plans) | $8 | 95% |
| Cca - Zing Health | $9 | 106% |
| UnitedHealthcare | $9 - $79 | 106% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $10 | 118% |
| Molina Marketplace | $11 | 130% |
| Bcn Domestic | $12 | 142% |
| Blue Benefit Administrators Of Massachusetts | $12 | 142% |
| Blue Care Network | $12 | 142% |
| Blue Distinction Transplant | $12 | 142% |
| Blue Shield - Ca | $12 | 142% |
| Blue Shield - Id (Regence) | $12 | 142% |
| Blue Shield - Ny Highmark Northeastern | $12 | 142% |
| Blue Shield - Ny Highmark Western | $12 | 142% |
| Blue Shield - Pa (Highmark) | $12 | 142% |
| Blue Shield - Wa (Regence) | $12 | 142% |
| Health Choices | $12 - $77 | 142% |
| Kaiser Domestic | $12 | 142% |
| Geha | $13 - $79 | 154% |
| Health Cost Solutions | $13 | 154% |
| Medical Mutual | $13 | 154% |
| Meritain | $13 | 154% |
| Priority Health | $13 - $14 | 154% |
| Vitalcore | $13 | 154% |
| Wellpath | $13 | 154% |
| U Of M Health Plan | $14 | 165% |
| Employee Benefit Logistic | $19 | 225% |
| Asr Health Benefits | $28 | 331% |
| Caresource | $28 | 331% |
| Hap | $28 - $76 | 331% |
| Varipro | $28 | 331% |
| Wc Accident Fund | $32 | 378% |
| Wc Advantage | $32 | 378% |
| Wc Aig | $32 | 378% |
| Wc Allied | $32 | 378% |
| Wc Amerisure | $32 | 378% |
| Wc Amtrust | $32 | 378% |
| Wc Asu Risk Mgt | $32 | 378% |
| Wc Berkley Admin | $32 | 378% |
| Wc Broadspire | $32 | 378% |
| Wc Bunch & Associates | $32 | 378% |
| Wc Ccmsi | $32 | 378% |
| Wc Emc Insurance Company | $32 | 378% |
| Wc Esis | $32 | 378% |
| Wc Fcci | $32 | 378% |
| Wc Federated | $32 | 378% |
| Wc Gallagher Bassett | $32 | 378% |
| Wc Genex Care For Ohio | $32 | 378% |
| Wc Guard Insurance Company | $32 | 378% |
| Wc Hartford | $32 | 378% |
| Wc Liberty Mutual | $32 | 378% |
| Wc Meijers | $32 | 378% |
| Wc Michigan | $32 | 378% |
| Wc Mitchell Frankenmuth | $32 | 378% |
| Wc Pma | $32 | 378% |
| Wc Sedgwick | $32 | 378% |
| Wc Sentry | $32 | 378% |
| Wc Travelers | $32 | 378% |
| Wc Tristar | $32 | 378% |
| Wc Walmart | $32 | 378% |
| Wc Zurich | $32 | 378% |
| Acs Benefit Services | $46 | 544% |
| Allied Benefit Systems | $46 | 544% |
| Claimchoice Adminstrators | $46 | 544% |
| Consociate | $46 | 544% |
| Cypress Benefit Administrators | $46 | 544% |
| Forest County Potawatomi | $46 | 544% |
| Health Smart | $46 | 544% |
| Healthgram | $46 | 544% |
| Healthscope | $46 | 544% |
| Secureone Preferred United Plans | $46 | 544% |
| Sisco Benefits | $46 | 544% |
| The Health Plan | $46 | 544% |
| Trustmark Small Business Benefits | $46 | 544% |
| Unified Group Services | $46 | 544% |
| Webtpa | $46 | 544% |
| Mclaren Health | $50 - $55 | 591% |
| Carelon Behavioral Health | $52 | 615% |
| Magellan Behavioral Health | $63 | 745% |
| 1199 National Benefit Fund | $71 | 839% |
| Allied National Global Care | $71 | 839% |
| Asrm - Reliance Standard Life Insurance | $71 | 839% |
| Christian Care Ministry | $71 | 839% |
| Dean Health | $71 | 839% |
| Fallon Health | $71 | 839% |
| Family Life Insurance Company | $71 | 839% |
| Ghc Scw | $71 | 839% |
| Group Pension Administrators | $71 | 839% |
| International Benefit Administrators | $71 | 839% |
| Lifetime Benefit Solutions | $71 | 839% |
| Manhattan Life | $71 | 839% |
| Medi Share | $71 | 839% |
| Multiplan | $71 | 839% |
| Mvp | $71 | 839% |
| Pai | $71 | 839% |
| Pan-American Life | $71 | 839% |
| Paramount Hmo | $71 | 839% |
| Phcs | $71 | 839% |
| Trinity Health Share | $71 | 839% |
| Health Partners | $76 | 898% |
| Tufts Health Plan | $76 | 898% |
| Access Health | $77 | 910% |
| Acclaim | $77 | 910% |
| Administrative Concepts | $77 | 910% |
| Allegeant | $77 | 910% |
| Ameriben | $77 | 910% |
| American Family | $77 | 910% |
| American Healthcare Alliance | $77 | 910% |
| American National | $77 | 910% |
| American Republic | $77 | 910% |
| Amerihealth | $77 | 910% |
| Aultcare | $77 | 910% |
| Automated Benefit Services | $77 | 910% |
| Auxiant | $77 | 910% |
| Benefit Administrative Systems,Llc | $77 | 910% |
| Boon Chapman | $77 | 910% |
| Cam Administrative Services | $77 | 910% |
| Christian Brother Services | $77 | 910% |
| Christian Brothers Holy Cross | $77 | 910% |
| Comprehensive Benefits | $77 | 910% |
| Continental Life Insurance | $77 | 910% |
| Custom Benefit Administrators | $77 | 910% |
| Employee Benefit Concepts | $77 | 910% |
| Employee Benefit Management | $77 | 910% |
| Enterprise Group Planning | $77 | 910% |
| Freedom Life Insurance Company | $77 | 910% |
| Group Administrators | $77 | 910% |
| Group Marketing Services | $77 | 910% |
| Guardian | $77 | 910% |
| Health America | $77 | 910% |
| Healthcare Management Admin | $77 | 910% |
| Healthez | $77 | 910% |
| Humana | $77 | 910% |
| Insight | $77 | 910% |
| Intercare | $77 | 910% |
| Jfp Benefit Management | $77 | 910% |
| Jp Farley Corporation | $77 | 910% |
| Key Benefit Administrator | $77 | 910% |
| Liberty Union Life Assurance Co | $77 | 910% |
| Lucent Health | $77 | 910% |
| Luminare Health | $77 | 910% |
| Luminare Health (Detroit) | $77 | 910% |
| Magnacare | $77 | 910% |
| Medben | $77 | 910% |
| Medcost | $77 | 910% |
| Mutual Health Services | $77 | 910% |
| Mutual Of Omaha | $77 | 910% |
| Ncas | $77 | 910% |
| Nippon Life Ins | $77 | 910% |
| Nova | $77 | 910% |
| Painters Union Insurance Fund | $77 | 910% |
| Physicians Mutual | $77 | 910% |
| Plumbers Local 98 Insurance Fund | $77 | 910% |
| Prairie States | $77 | 910% |
| Preferred One | $77 | 910% |
| Primary Physician Care | $77 | 910% |
| Professional Benefit Administrators | $77 | 910% |
| Siho Insurance Services | $77 | 910% |
| The Loomis Company | $77 | 910% |
| Unicare | $77 | 910% |
| Us Health And Life | $77 | 910% |
| Valenz | $77 | 910% |
| Western & Southern Financial Group | $77 | 910% |
| Wps | $77 | 910% |
| Cigna | $78 | 922% |
| Coventry | $79 | 934% |
| First Health | $79 | 934% |
| Prime Health Services | $84 | 993% |
| Three Rivers Provider Network | $94 | 1111% |
| 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 Oakland County | $105 | 1241% |
| Cmh Washtenaw County | $105 | 1241% |