CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: St Joseph's University Medical Center Inc

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $18
  • Cash Discount Price: $256
  • vs. Medicare Baseline: 2.13x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at St Joseph's University Medical Center Inc is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $256. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 2.13x the Medicare baseline. Located in 703 Main St, Paterson, NJ.
Cash / Self-Pay
$256

Average discount available for prompt cash payment at this facility.

Insurance Median
$18

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: $256 (3026%)
Insurance Median: $18 (213%)
Cash: $256 (3026% of Medicare)
Ins. Median: $18 (213% 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 213% of the Medicare baseline (a markup of 113%). 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
Aetna $8 - $53 95%
Amerihealth $8 - $163 95%
Blue Cross Blue Shield $8 - $223 95%
Clover Health $8 95%
Horizon New Jersey Total Care $8 95%
UnitedHealthcare $8 - $18 95%
Wellpoint $8 - $10 95%
Fidelis Care of New Jersey $9 - $51 106%
Longevity Health Plan $10 118%
Ambetter / Centene $13 154%
Horizon New Jersey Health $15 177%
Oxford $18 213%
Private Healthcare Systems $166 1962%
Magnacare $179 2116%
Multiplan $192 2270%
Consumer Health Network $230 2719%
Oscar $241 2849%
Cigna $256 3026%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 703 Main St, Paterson, NJ 07503
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals