CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Saint Michael's Medical Center

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $9
  • Cash Discount Price: $8
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Saint Michael's Medical Center is $9. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 1.06x the Medicare baseline. Located in 111 Central Avenue, Newark, NJ.
Cash / Self-Pay
$8

Average discount available for prompt cash payment at this facility.

Insurance Median
$9

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: $8 (95%)
Insurance Median: $9 (106%)
Cash: $8 (95% of Medicare)
Ins. Median: $9 (106% 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.

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
UnitedHealthcare $5 - $8 59%
Tricare $7 83%
Aetna $8 - $18 95%
Amerihealth $8 95%
Horizon $8 - $62 95%
Humana $8 95%
Medicare (plans) $8 95%
New Jersey Out of State $8 95%
Wellpoint Amerigroup $8 95%
Clover Health $9 106%
Curana $9 106%
Wellcare $9 - $11 106%
Fairprice Healthcare Holdings - Fphh $10 118%
Cigna $12 142%
Employer Direct Healthcare $12 142%
Naphcare $13 154%
Coventry $17 201%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 111 Central Avenue, Newark, NJ 07102
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals