CMS Price Transparency Data
Blood test, basic metabolic panel
Facility: Mercy Health Lakeshore Campus
Billing Code: 80048 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80048
- Insurance Median: $60
- Cash Discount Price: $46
- vs. Medicare Baseline: 7.09x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Mercy Health Lakeshore Campus is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 7.09x the Medicare baseline. Located in 72 South State Street, Shelby, MI.
Cash / Self-Pay
$46
Average discount available for prompt cash payment at this facility.
Insurance Median
$60
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: $46 (544%)
Insurance Median: $60 (709%)
Cash: $46 (544% of Medicare)
Ins. Median: $60 (709% 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 709% of the Medicare baseline (a markup of 609%). 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 | $6 - $60 | 71% |
| Medicaid / KanCare | $6 | 71% |
| Access Health | $8 | 95% |
| Aetna | $8 - $56 | 95% |
| Align Senior Care | $8 | 95% |
| Blue Care Network Advantage | $8 | 95% |
| Correctional Recovery | $8 | 95% |
| Medicare (plans) | $8 | 95% |
| UnitedHealthcare | $8 - $63 | 95% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $10 | 118% |
| Vitalcore | $13 | 154% |
| Wellpath | $13 | 154% |
| U Of M Health Plan | $14 - $63 | 165% |
| Oscar | $22 | 260% |
| Molina Marketplace | $29 | 343% |
| Hospice Of Michigan | $38 | 449% |
| Nomi Health | $39 | 461% |
| Hap | $52 | 615% |
| Wc Accident Fund | $55 | 650% |
| Wc Advantage | $55 | 650% |
| Wc Aig | $55 | 650% |
| Wc Allied | $55 | 650% |
| Wc Amerisure | $55 | 650% |
| Wc Amtrust | $55 | 650% |
| Wc Asu Risk Mgt | $55 | 650% |
| Wc Berkley Admin | $55 | 650% |
| Wc Broadspire | $55 | 650% |
| Wc Bunch & Associates | $55 | 650% |
| Wc Ccmsi | $55 | 650% |
| Wc Emc Insurance Company | $55 | 650% |
| Wc Esis | $55 | 650% |
| Wc Fcci | $55 | 650% |
| Wc Federated | $55 | 650% |
| Wc Gallagher Bassett | $55 | 650% |
| Wc Genex Care For Ohio | $55 | 650% |
| Wc Guard Insurance Company | $55 | 650% |
| Wc Hartford | $55 | 650% |
| Wc Liberty Mutual | $55 | 650% |
| Wc Meijers | $55 | 650% |
| Wc Michigan | $55 | 650% |
| Wc Mitchell Frankenmuth | $55 | 650% |
| Wc Pma | $55 | 650% |
| Wc Sedgwick | $55 | 650% |
| Wc Sentry | $55 | 650% |
| Wc Travelers | $55 | 650% |
| Wc Tristar | $55 | 650% |
| Wc Walmart | $55 | 650% |
| Wc Zurich | $55 | 650% |
| Geha | $56 - $63 | 662% |
| Meritain | $56 | 662% |
| Asr Health Benefits | $58 | 686% |
| 1199 National Benefit Fund | $60 | 709% |
| Allied National Global Care | $60 | 709% |
| Asrm - Reliance Standard Life Insurance | $60 | 709% |
| Bcn Domestic | $60 | 709% |
| Blue Benefit Administrators Of Massachusetts | $60 | 709% |
| Blue Care Network | $60 | 709% |
| Blue Distinction Transplant | $60 | 709% |
| Blue Shield - Ca | $60 | 709% |
| Blue Shield - Id (Regence) | $60 | 709% |
| Blue Shield - Ny Highmark Northeastern | $60 | 709% |
| Blue Shield - Ny Highmark Western | $60 | 709% |
| Blue Shield - Pa (Highmark) | $60 | 709% |
| Blue Shield - Wa (Regence) | $60 | 709% |
| Christian Care Ministry | $60 | 709% |
| Dean Health | $60 | 709% |
| Fallon Health | $60 | 709% |
| Family Life Insurance Company | $60 | 709% |
| Ghc Scw | $60 | 709% |
| Group Pension Administrators | $60 | 709% |
| Health Choices | $60 - $63 | 709% |
| International Benefit Administrators | $60 | 709% |
| Kaiser Domestic | $60 | 709% |
| Lifetime Benefit Solutions | $60 | 709% |
| Manhattan Life | $60 | 709% |
| Medi Share | $60 | 709% |
| Multiplan | $60 | 709% |
| Mvp | $60 | 709% |
| Pai | $60 | 709% |
| Pan-American Life | $60 | 709% |
| Paramount Hmo | $60 | 709% |
| Phcs | $60 | 709% |
| Trinity Health Share | $60 | 709% |
| Cigna | $61 | 721% |
| Acclaim | $63 | 745% |
| Administrative Concepts | $63 | 745% |
| Allegeant | $63 | 745% |
| Allied Benefit Systems | $63 | 745% |
| Ameriben | $63 | 745% |
| American Family | $63 | 745% |
| American Healthcare Alliance | $63 | 745% |
| American Republic | $63 | 745% |
| Amerihealth | $63 | 745% |
| Aultcare | $63 | 745% |
| Automated Benefit Services | $63 | 745% |
| Auxiant | $63 | 745% |
| Benefit Administrative Systems,Llc | $63 | 745% |
| Boon Chapman | $63 | 745% |
| Cam Administrative Services | $63 | 745% |
| Christian Brother Services | $63 | 745% |
| Christian Brothers Holy Cross | $63 | 745% |
| Claimchoice Adminstrators | $63 | 745% |
| Comprehensive Benefits | $63 | 745% |
| Consociate | $63 | 745% |
| Continental Life Insurance | $63 | 745% |
| Custom Benefit Administrators | $63 | 745% |
| Cypress Benefit Administrators | $63 | 745% |
| Employee Benefit Concepts | $63 | 745% |
| Employee Benefit Management | $63 | 745% |
| Enterprise Group Planning | $63 | 745% |
| First Health | $63 | 745% |
| Forest County Potawatomi | $63 | 745% |
| Freedom Life Insurance Company | $63 | 745% |
| Group Administrators | $63 | 745% |
| Group Marketing Services | $63 | 745% |
| Guardian | $63 | 745% |
| Health America | $63 | 745% |
| Health Smart | $63 | 745% |
| Healthez | $63 | 745% |
| Healthgram | $63 | 745% |
| Healthscope | $63 | 745% |
| Humana | $63 | 745% |
| Insight | $63 | 745% |
| Intercare | $63 | 745% |
| Jfp Benefit Management | $63 | 745% |
| Jp Farley Corporation | $63 | 745% |
| Key Benefit Administrator | $63 | 745% |
| Liberty Union Life Assurance Co | $63 | 745% |
| Lucent Health | $63 | 745% |
| Luminare Health | $63 | 745% |
| Luminare Health (Detroit) | $63 | 745% |
| Medben | $63 | 745% |
| Medcost | $63 | 745% |
| Medical Mutual | $63 | 745% |
| Mutual Health Services | $63 | 745% |
| Mutual Of Omaha | $63 | 745% |
| Ncas | $63 | 745% |
| Nippon Life Ins | $63 | 745% |
| Nova | $63 | 745% |
| Painters Union Insurance Fund | $63 | 745% |
| Physicians Mutual | $63 | 745% |
| Plumbers Local 98 Insurance Fund | $63 | 745% |
| Prairie States | $63 | 745% |
| Primary Physician Care | $63 | 745% |
| Priority Health | $63 | 745% |
| Professional Benefit Administrators | $63 | 745% |
| Secureone Preferred United Plans | $63 | 745% |
| The Loomis Company | $63 | 745% |
| Trustmark Small Business Benefits | $63 | 745% |
| Unicare | $63 | 745% |
| Unified Group Services | $63 | 745% |
| Us Health And Life | $63 | 745% |
| Valenz | $63 | 745% |
| Varipro | $63 | 745% |
| Western & Southern Financial Group | $63 | 745% |
| Wps | $63 | 745% |