CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Essentia Health St Mary's Medical Center

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $110
  • Cash Discount Price: $162
  • vs. Medicare Baseline: 13.00x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Essentia Health St Mary's Medical Center is $110. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $162. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 13.00x the Medicare baseline. Located in 402 East Second Street, Duluth, MN.
Cash / Self-Pay
$162

Average discount available for prompt cash payment at this facility.

Insurance Median
$110

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: $162 (1915%)
Insurance Median: $110 (1300%)
Cash: $162 (1915% of Medicare)
Ins. Median: $110 (1300% 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 1300% of the Medicare baseline (a markup of 1200%). 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
Advocare/Security Health $8 95%
Blue Cross Blue Shield $8 - $186 95%
Freedom Blue Ppo $8 95%
Healthpartners Care Msho / Mcr Adv $8 95%
Imcare Msho (Ref Req) $8 95%
Imcare Msho Pcc Prime $8 95%
Imcare Msho Ref Req $8 95%
Itasca Med Care $8 95%
Medica Advantage Solutions $8 95%
Medica Msho/Dual Solutions $8 95%
Medica Prime Solution Group $8 95%
Medicare (plans) $8 95%
Nd Va Administration $8 95%
Platinum Blue / Vantage Blue $8 95%
Primewest $8 95%
Primewest Msho $8 95%
Secure Blue Msho $8 95%
Ubh Cost Plan $8 95%
Ubh Msho $8 95%
Ucare Msho $8 95%
UnitedHealthcare $8 - $179 95%
Sanford Health Plan $27 - $111 319%
Medica Access $81 957%
Healthpartners Care Pmap $98 1158%
Blue Plus Pmap Pcc Prime $108 - $122 1277%
Medica $135 - $139 1596%
Medica Uplan $135 1596%
Healthpartners $147 - $175 1738%
Medica Choice $150 1773%
Ucare $161 1903%
Cigna $175 2069%
Healthpartners Pcc Prime $175 2069%
Wea $176 - $189 2080%
Security Health $189 2234%
America'S Ppo $190 2246%
Wps $203 - $206 2400%
Aetna $208 2459%
Healthscope Benefits $208 2459%
Healtheos $211 2494%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 402 East Second Street, Duluth, MN 55805
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals