CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: St Mary's Healthcare

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $26
  • Cash Discount Price: $208
  • vs. Medicare Baseline: 3.07x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at St Mary's Healthcare is $26. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $208. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 3.07x the Medicare baseline. Located in 427 Guy Park Avenue, Amsterdam, NY.
Cash / Self-Pay
$208

Average discount available for prompt cash payment at this facility.

Insurance Median
$26

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: $208 (2459%)
Insurance Median: $26 (307%)
Cash: $208 (2459% of Medicare)
Ins. Median: $26 (307% 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 307% of the Medicare baseline (a markup of 207%). 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
Medicare (plans) $8 - $9 95%
Tricare $8 95%
Va $8 95%
Aetna $9 - $226 106%
Blue Cross Blue Shield $9 - $211 106%
Humana $9 106%
Medicaid / KanCare $26 - $29 307%
UnitedHealthcare $26 307%
Carelon_Commercial $151 1785%
Carelon_Empire $151 1785%
Emblem_Commercial $181 2139%
Cdphp_Commercial $211 2494%
Excellus_Commercial $223 2636%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 427 Guy Park Avenue, Amsterdam, NY 12010
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals