CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Southwest General Health Center

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $64
Cash Discount Price: $101
vs. Medicare Baseline: 7.57x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Southwest General Health Center is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $101. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 7.57x the Medicare baseline. Located in 18697 Bagley Road, Middleburg Heights, OH.

Cash / Self-Pay

$101

Average discount available for prompt cash payment at this facility.

Insurance Median

$64

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: $101 (1194%)

Insurance Median: $64 (757%)

Cash: $101 (1194% of Medicare)

Ins. Median: $64 (757% 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 757% of the Medicare baseline (a markup of 657%). 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
Medical Mutual	$4	47%
Medical Mutual-Ohio	$4	47%
Buckeye	$11 - $64	130%
Molina	$11 - $64	130%
Cigna	$20	236%
Healthsmart	$43	508%
Health Design Plus	$50	591%
Humana	$53 - $64	626%
Clarity Health	$54	638%
Healthspan	$54	638%
Healthsmart Preferred	$61	721%
Amerihealth Caritas	$64	757%
Blue Cross Blue Shield	$64	757%
Caresource	$64	757%
UnitedHealthcare	$64 - $73	757%
Ohio Health Choice Plus	$65	768%
Aetna	$73	863%
Summacare	$73	863%
Coventry	$93	1099%
First Health	$93	1099%
Ohio Health Choice	$104	1229%
Private Healthare Systems	$108	1277%

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 $101.
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 Southwest General Health 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.