CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: UPMC Chautauqua at Wca

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $13
Cash Discount Price: $20
vs. Medicare Baseline: 1.54x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at UPMC Chautauqua at Wca is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 1.54x the Medicare baseline. Located in 207 Foote Avenue, Jamestown, NY.

Cash / Self-Pay

$20

Average discount available for prompt cash payment at this facility.

Insurance Median

$13

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: $20 (236%)

Insurance Median: $13 (154%)

Cash: $20 (236% of Medicare)

Ins. Median: $13 (154% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Beacon	$8 - $11	95%
Fidelis	$8	95%
Geisinger	$8 - $13	95%
Humana	$8 - $27	95%
United Behavioral Health	$8	95%
UnitedHealthcare	$8 - $22	95%
Upmc Health Plan	$8 - $20	95%
Aetna	$9 - $22	106%
Health Partners Plans (Jefferson Health Plan)	$9	106%
Independent Health	$9	106%
Univera	$9	106%
Wellcare	$9	106%
Magnacare	$13 - $26	154%
Blue Cross Blue Shield	$21	248%
Multiplan	$26	307%
Ghi/Emblem Health	$27	319%
Statewide Independent Ppo	$30	355%
Affordable First Health	$31	366%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $20.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80048.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UPMC Chautauqua at Wca is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 80048.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.