CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: St James Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $83
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 9.81x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at St James Hospital is $83. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 9.81x the Medicare baseline. Located in 400 S Clark St, Butte, MT.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$83

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%)
Insurance Median: $83 (981%)
Ins. Median: $83 (981% 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 981% of the Medicare baseline (a markup of 881%). 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
Humana $9 106%
UnitedHealthcare $9 - $79 106%
Coastal Administrative Services $18 213%
Allegiance $21 - $88 248%
First Choice Health $41 - $83 485%
Ebms-Employee Benefit Mng $47 - $83 556%
Cigna $48 - $88 567%
Pacificsource $56 - $88 662%
Blue Cross Blue Shield $67 - $92 792%
Geha $79 934%
Mt Health Co-Op $84 993%
Aetna $88 1040%
Interwest $88 1040%
Meritain Health $88 1040%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 S Clark St, Butte, MT 59701
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals