CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Samaritan Hospital of Troy, New York

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $22
  • Cash Discount Price: $155
  • vs. Medicare Baseline: 2.60x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Samaritan Hospital of Troy, New York is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $155. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 2.60x the Medicare baseline. Located in 2215 Burdett Avenue, Troy, NY.
Cash / Self-Pay
$155

Average discount available for prompt cash payment at this facility.

Insurance Median
$22

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: $155 (1832%)
Insurance Median: $22 (260%)
Cash: $155 (1832% of Medicare)
Ins. Median: $22 (260% 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 260% of the Medicare baseline (a markup of 160%). 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
Albany County Correctional Facility $7 83%
Nascentia Health Options $7 83%
Blue Cross Blue Shield $8 - $39 95%
Eddy Seniorcare Pace $8 95%
Medicaid / KanCare $8 - $126 95%
Medicare (plans) $8 - $126 95%
Aetna $9 - $28 106%
Hudson Headwaters Pace $9 106%
Mvp $9 106%
Nascentia Health Plus $9 106%
Secure Horizons Ma Pffs $9 106%
UnitedHealthcare $9 - $126 106%
Fidelis Care $15 177%
Wellpath $19 225%
Harvard Pilgrim Healthcare $21 248%
Bcn Domestic $22 260%
Blue Care Network $22 260%
Unicare $22 260%
Blue Shield - Ny Highmark Northeastern $24 - $39 284%
1199 National Benefit Fund $28 331%
Allied Benefit Systems $28 331%
Asr Health Benefits $28 331%
Christian Brother Services $28 331%
Geha $28 331%
Lucent Health $28 331%
Luminare Health $28 331%
Medical Mutual $28 331%
Meritain $28 331%
Trustmark Small Business Benefits $28 331%
Blue Shield - Ca $39 461%
Blue Shield - Id (Regence) $39 461%
Blue Shield - Ny Highmark Western $39 461%
Blue Shield - Pa (Highmark) $39 461%
Blue Shield - Wa (Regence) $39 461%
Allegiance $57 674%
American Postal Workers Secondary $57 674%
Cigna $57 674%
Diversified Administrators $57 674%
Health Partners $57 674%
Priority Health $57 674%
Tufts Health Plan $57 674%
Webtpa $57 674%
Emblem Health $63 745%
Nova $63 745%
First Health $101 1194%
Health Republic $107 1265%
Independent Health $107 1265%
Magnacare $107 1265%
Health New England $113 1336%
Multiplan $113 1336%
Phcs $113 1336%
Carelon Behavioral Health $126 1489%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2215 Burdett Avenue, Troy, NY 12180
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals