CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Wooster Community Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $46
  • Cash Discount Price: $61
  • vs. Medicare Baseline: 5.44x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Wooster Community Hospital is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $61. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 5.44x the Medicare baseline. Located in 1761 Beall Avenue, Wooster, OH.
Cash / Self-Pay
$61

Average discount available for prompt cash payment at this facility.

Insurance Median
$46

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: $61 (721%)
Insurance Median: $46 (544%)
Cash: $61 (721% of Medicare)
Ins. Median: $46 (544% 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 544% of the Medicare baseline (a markup of 444%). 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
Blue Cross Blue Shield $5 - $18 59%
Buckeye Mcare $8 95%
Caresource Mcr Adv $8 95%
Humana $8 - $58 95%
Med Mutual Of Oh Mcr $8 95%
Molina Mcr $8 95%
Summacare Mcr $8 95%
The Health Plan Mcr Adv $8 95%
Tricare $8 95%
UnitedHealthcare $8 - $58 95%
Valor Hp Mcr-All Plans $8 95%
Magnipower-All Plans $11 130%
Caresource Exch - All Other Plans $12 142%
Molina Marketplace - All Other Plans $14 165%
Clarity Health - All Plans $16 189%
Buckeye Mcaid-All Other Plans $17 201%
Caresource Mcaid $17 201%
Aetna $18 - $61 213%
Amerihealth Mcaid-All Plans $18 213%
Molina Mcaid $18 213%
Aultcare/Primecare Mcr Adv $30 355%
Cerco-All Plans $43 508%
Aultcare Wayne County $46 544%
Aultcare/Primetime Exch $46 544%
Rayco-All Plans $46 544%
Christian Health Ministries-All Plans $49 579%
Cigna $49 579%
Health Ohio Network Employer $49 579%
Wayne County-All Plans $49 579%
Healthsmart Accel $51 603%
Summacare Preferred Choice $51 603%
Health Ohio Network Ppo-All Other Plans $52 615%
Healthsmart Complete Ppo-All Other Plans $52 615%
Ohio Health Choice Supp $52 615%
Ohio Health Group Hlthy - All Other Plans $52 615%
Med Mutual Of Oh Exchange $53 626%
Med Mutual Of Oh Supermed $53 626%
Med Mutual Of Oh Trad-All Other Plans $53 626%
Health Plan Of Upper Ohio-All Plans $54 638%
The Health Plan Comm - All Other Plans $54 638%
Aultcare/Primetime-All Other Plans $55 650%
Ohio Health Group Pref $55 650%
Healthsmart Ppo $56 662%
Summacare-All Other Plans $57 674%
Healthsmart Hpo $58 686%
Ohio Health Choice-All Other Plans $58 686%
Osu-All Plans $58 686%
Central Benefits-All Plans $59 697%
First Health-All Plans $59 697%
Flora-All Plans $59 697%
Beech Street-All Plans $60 709%
Phcs-All Plans $60 709%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1761 Beall Avenue, Wooster, OH 44691
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals