CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $21
  • Cash Discount Price: $85
  • vs. Medicare Baseline: 2.48x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Munson Healthcare Otsego Memorial Hospital is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $85. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 2.48x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.
Cash / Self-Pay
$85

Average discount available for prompt cash payment at this facility.

Insurance Median
$21

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: $85 (1005%)
Insurance Median: $21 (248%)
Cash: $85 (1005% of Medicare)
Ins. Median: $21 (248% 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 248% of the Medicare baseline (a markup of 148%). 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.

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
UnitedHealthcare $3 - $80 35%
Blue Cross Blue Shield $4 - $62 47%
Mclaren Health Plan $4 - $84 47%
Meridian $4 47%
Molina $4 - $9 47%
Priority Health $4 - $28 47%
Aetna $7 - $81 83%
Blue Care Network $8 95%
Hap (Health Alliance Plan) $8 - $80 95%
Humana $8 95%
Medicare (plans) $8 95%
Michigan Amish Medical Board $8 95%
Northern Michigan Mennonite Group $8 95%
Cigna $9 - $28 106%
Employee Benefit Logistics $14 165%
Hospice Of Michigan $60 709%
Munson Hospice $70 - $852 827%
Asr Physicians Care Network $80 946%
Enterprise Group Planning/Employee Benefit Plan $80 946%
Nomi Health $80 946%
Cofinity $85 - $90 1005%
Provider Network Of America/Hawaii Mainland Administrative Group Health $85 1005%
Three Rivers Provider Network $85 1005%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 825 N Center Ave, Gaylord, MI 49735
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals