CMS Price Transparency Data
Blood test, basic metabolic panel
Facility: Mercy Health Saint Mary's
Billing Code: 80048 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80048
- Insurance Median: $40
- Cash Discount Price: $80
- vs. Medicare Baseline: 4.73x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Mercy Health Saint Mary's is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 4.73x the Medicare baseline. Located in 200 Jefferson Avenue Se, Grand Rapids, MI.
Cash / Self-Pay
$80
Average discount available for prompt cash payment at this facility.
Insurance Median
$40
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: $80 (946%)
Insurance Median: $40 (473%)
Cash: $80 (946% of Medicare)
Ins. Median: $40 (473% 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 473% of the Medicare baseline (a markup of 373%). 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 - $15 | 59% |
| Medicaid / KanCare | $5 | 59% |
| Access Health | $6 | 71% |
| Aetna | $8 - $31 | 95% |
| Align Senior Care | $8 | 95% |
| Blue Care Network Advantage | $8 | 95% |
| Correctional Recovery | $8 | 95% |
| Hospice Faith | $8 | 95% |
| Hospice Of Holland | $8 | 95% |
| Medicare (plans) | $8 | 95% |
| Oscar | $8 | 95% |
| UnitedHealthcare | $9 - $70 | 106% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $10 | 118% |
| Molina Marketplace | $11 | 130% |
| Geha | $13 - $53 | 154% |
| Medical Mutual | $13 | 154% |
| Meritain | $13 | 154% |
| Preferred One | $13 | 154% |
| Vitalcore | $13 | 154% |
| Wellpath | $13 | 154% |
| U Of M Health Plan | $14 - $53 | 165% |
| Bcn Domestic | $15 | 177% |
| Blue Benefit Administrators Of Massachusetts | $15 | 177% |
| Blue Care Network | $15 | 177% |
| Blue Distinction Transplant | $15 | 177% |
| Blue Shield - Ca | $15 | 177% |
| Blue Shield - Id (Regence) | $15 | 177% |
| Blue Shield - Ny Highmark Northeastern | $15 | 177% |
| Blue Shield - Ny Highmark Western | $15 | 177% |
| Blue Shield - Pa (Highmark) | $15 | 177% |
| Blue Shield - Wa (Regence) | $15 | 177% |
| Health Choices | $15 - $53 | 177% |
| Kaiser Domestic | $15 | 177% |
| Wc Accident Fund | $38 | 449% |
| Wc Advantage | $38 | 449% |
| Wc Aig | $38 | 449% |
| Wc Allied | $38 | 449% |
| Wc Amerisure | $38 | 449% |
| Wc Amtrust | $38 | 449% |
| Wc Asu Risk Mgt | $38 | 449% |
| Wc Berkley Admin | $38 | 449% |
| Wc Broadspire | $38 | 449% |
| Wc Bunch & Associates | $38 | 449% |
| Wc Ccmsi | $38 | 449% |
| Wc Emc Insurance Company | $38 | 449% |
| Wc Esis | $38 | 449% |
| Wc Fcci | $38 | 449% |
| Wc Federated | $38 | 449% |
| Wc Gallagher Bassett | $38 | 449% |
| Wc Genex Care For Ohio | $38 | 449% |
| Wc Guard Insurance Company | $38 | 449% |
| Wc Hartford | $38 | 449% |
| Wc Liberty Mutual | $38 | 449% |
| Wc Meijers | $38 | 449% |
| Wc Michigan | $38 | 449% |
| Wc Mitchell Frankenmuth | $38 | 449% |
| Wc Pma | $38 | 449% |
| Wc Sedgwick | $38 | 449% |
| Wc Sentry | $38 | 449% |
| Wc Travelers | $38 | 449% |
| Wc Tristar | $38 | 449% |
| Wc Walmart | $38 | 449% |
| Wc Zurich | $38 | 449% |
| Nomi Health | $39 | 461% |
| Acs Benefit Services | $40 | 473% |
| Allied Benefit Systems | $40 | 473% |
| Claimchoice Adminstrators | $40 | 473% |
| Consociate | $40 | 473% |
| Cypress Benefit Administrators | $40 | 473% |
| Forest County Potawatomi | $40 | 473% |
| Health Smart | $40 | 473% |
| Healthgram | $40 | 473% |
| Healthscope | $40 | 473% |
| Secureone Preferred United Plans | $40 | 473% |
| Sisco Benefits | $40 | 473% |
| The Health Plan | $40 | 473% |
| Trustmark Small Business Benefits | $40 | 473% |
| Unified Group Services | $40 | 473% |
| Webtpa | $40 | 473% |
| Asr Health Benefits | $45 | 532% |
| Hap | $45 - $54 | 532% |
| Varipro | $45 | 532% |
| Caresource | $46 | 544% |
| 1199 National Benefit Fund | $51 | 603% |
| Allied National Global Care | $51 | 603% |
| Asrm - Reliance Standard Life Insurance | $51 | 603% |
| Christian Care Ministry | $51 | 603% |
| Cigna | $51 | 603% |
| Dean Health | $51 | 603% |
| Fallon Health | $51 | 603% |
| Family Life Insurance Company | $51 | 603% |
| Ghc Scw | $51 | 603% |
| Group Pension Administrators | $51 | 603% |
| International Benefit Administrators | $51 | 603% |
| Lifetime Benefit Solutions | $51 | 603% |
| Manhattan Life | $51 | 603% |
| Medi Share | $51 | 603% |
| Multiplan | $51 | 603% |
| Mvp | $51 | 603% |
| Pai | $51 | 603% |
| Pan-American Life | $51 | 603% |
| Paramount Hmo | $51 | 603% |
| Phcs | $51 | 603% |
| Priority Health | $51 - $52 | 603% |
| Trinity Health Share | $51 | 603% |
| Acclaim | $53 | 626% |
| Administrative Concepts | $53 | 626% |
| Allegeant | $53 | 626% |
| Ameriben | $53 | 626% |
| American Family | $53 | 626% |
| American Healthcare Alliance | $53 | 626% |
| American Republic | $53 | 626% |
| Amerihealth | $53 | 626% |
| Aultcare | $53 | 626% |
| Automated Benefit Services | $53 | 626% |
| Auxiant | $53 | 626% |
| Benefit Administrative Systems,Llc | $53 | 626% |
| Boon Chapman | $53 | 626% |
| Cam Administrative Services | $53 | 626% |
| Christian Brother Services | $53 | 626% |
| Christian Brothers Holy Cross | $53 | 626% |
| Comprehensive Benefits | $53 | 626% |
| Continental Life Insurance | $53 | 626% |
| Custom Benefit Administrators | $53 | 626% |
| Employee Benefit Concepts | $53 | 626% |
| Employee Benefit Management | $53 | 626% |
| Enterprise Group Planning | $53 | 626% |
| Freedom Life Insurance Company | $53 | 626% |
| Group Administrators | $53 | 626% |
| Group Marketing Services | $53 | 626% |
| Guardian | $53 | 626% |
| Health America | $53 | 626% |
| Healthez | $53 | 626% |
| Humana | $53 - $70 | 626% |
| Insight | $53 | 626% |
| Intercare | $53 | 626% |
| Jfp Benefit Management | $53 | 626% |
| Jp Farley Corporation | $53 | 626% |
| Key Benefit Administrator | $53 | 626% |
| Liberty Union Life Assurance Co | $53 | 626% |
| Lucent Health | $53 | 626% |
| Luminare Health | $53 | 626% |
| Luminare Health (Detroit) | $53 | 626% |
| Medben | $53 | 626% |
| Medcost | $53 | 626% |
| Mutual Health Services | $53 | 626% |
| Mutual Of Omaha | $53 | 626% |
| Ncas | $53 | 626% |
| Nippon Life Ins | $53 | 626% |
| Nova | $53 | 626% |
| Painters Union Insurance Fund | $53 | 626% |
| Physicians Mutual | $53 | 626% |
| Plumbers Local 98 Insurance Fund | $53 | 626% |
| Prairie States | $53 | 626% |
| Primary Physician Care | $53 | 626% |
| Professional Benefit Administrators | $53 | 626% |
| The Loomis Company | $53 | 626% |
| Unicare | $53 | 626% |
| Us Health And Life | $53 | 626% |
| Valenz | $53 | 626% |
| Western & Southern Financial Group | $53 | 626% |
| Wps | $53 | 626% |
| Coventry | $55 | 650% |
| First Health | $55 | 650% |
| Cmh Allegan County | $70 | 827% |
| Cmh Ausable Valley | $70 | 827% |
| Cmh Barry County | $70 | 827% |
| Cmh Berrien County | $70 | 827% |
| Cmh Cass County | $70 | 827% |
| Cmh Clinton-Eaton-Ingham County | $70 | 827% |
| Cmh Kalamazoo | $70 | 827% |
| Cmh Kent County | $70 | 827% |
| Cmh Lenawee County | $70 | 827% |
| Cmh Misc | $70 | 827% |
| Cmh Monroe County | $70 | 827% |
| Cmh Montcalm County | $70 | 827% |
| Cmh Muskegon County | $70 | 827% |
| Cmh Newaygo County | $70 | 827% |
| Cmh North Country | $70 | 827% |
| Cmh Northern Lakes County | $70 | 827% |
| Cmh Ottawa County | $70 | 827% |
| Cmh Van Buren County | $70 | 827% |
| Cmh West Mi County | $70 | 827% |
| Magellan Behavioral Health | $70 | 827% |