CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Essentia Health Ada

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $113
Cash Discount Price: $174
vs. Medicare Baseline: 13.36x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Essentia Health Ada is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $174. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 13.36x the Medicare baseline. Located in 201 9Th Street West, Ada, MN.

Cash / Self-Pay

$174

Average discount available for prompt cash payment at this facility.

Insurance Median

$113

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: $174 (2057%)

Insurance Median: $113 (1336%)

Cash: $174 (2057% of Medicare)

Ins. Median: $113 (1336% 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 1336% of the Medicare baseline (a markup of 1236%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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 - $113	95%
Blue Cross Blue Shield	$8 - $205	95%
Freedom Blue Ppo	$8 - $113	95%
Healthpartners Care Msho / Mcr Adv	$8 - $113	95%
Imcare Msho Pcc Prime	$8 - $113	95%
Imcare Msho Ref Req	$8 - $113	95%
Itasca Med Care	$8	95%
Medica Advantage Solutions	$8 - $113	95%
Medica Msho/Dual Solutions	$8 - $113	95%
Medica Prime Solution Group	$8 - $113	95%
Medicare (plans)	$8 - $113	95%
Nd Va Administration	$8 - $113	95%
Platinum Blue/Vantage Blue	$8 - $113	95%
Primewest	$8	95%
Primewest Msho	$8 - $113	95%
Secure Blue Msho	$8 - $113	95%
Ubh Cost Plan	$8 - $113	95%
Ubh Msho	$8 - $113	95%
Ucare Msho	$8 - $113	95%
UnitedHealthcare	$8 - $213	95%
Healthpartners Care Pmap	$91	1076%
Medica Access	$94 - $146	1111%
Sanford Health Plan	$101 - $106	1194%
Blue Plus Pmap Pcc Prime	$129 - $205	1525%
Healthpartners	$143 - $156	1690%
Ucare	$155	1832%
Cigna	$156	1844%
Healthpartners Pcc Prime	$156	1844%
Wea	$169 - $181	1998%
America'S Ppo	$182	2151%
Medica	$195 - $206	2305%
Medica Uplan	$195	2305%
Wps	$195 - $197	2305%
Aetna	$200	2364%
Medica Choice	$212	2506%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $174.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80048.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Essentia Health Ada is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 80048.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.