CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Fairfield Medical Center

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $19
Cash Discount Price: $45
vs. Medicare Baseline: 2.25x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Fairfield Medical Center is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 2.25x the Medicare baseline. Located in 401 North Ewing Street, Lancaster, OH.

Cash / Self-Pay

$45

Average discount available for prompt cash payment at this facility.

Insurance Median

$19

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: $45 (532%)

Insurance Median: $19 (225%)

Cash: $45 (532% of Medicare)

Ins. Median: $19 (225% 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 225% of the Medicare baseline (a markup of 125%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Humana	$7 - $95	83%
Aetna	$8 - $66	95%
Allied Benefit Systems	$8 - $70	95%
Blue Cross Blue Shield	$8 - $26,250	95%
Buckeye Community Health	$8 - $19	95%
Caresource	$8 - $18	95%
Medical Mutual	$8 - $33,500	95%
Medicare (plans)	$8	95%
Medigold	$8	95%
Meritain Health	$8 - $70	95%
Molina	$8 - $18	95%
The Health Plan	$8 - $69	95%
UnitedHealthcare	$8 - $18	95%
Va Ccn	$8	95%
Valor Health Plan	$8	95%
Oscar	$9	106%
Bwc	$12	142%
Medicaid / KanCare	$18	213%
Amerihealth Caritas Ohio	$19	225%
Quality Care Partners/Ohio Ppo Connect	$72	851%
The Ohio State Health Plan	$77	910%
Cigna	$82	969%
Ohio Healthy	$94	1111%
Multiplan	$95	1123%
Miscellaneous Plans	$100	1182%

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 $45.
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 Fairfield Medical Center 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.