CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Licking Memorial Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $186
  • Cash Discount Price: $258
  • vs. Medicare Baseline: 21.99x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Licking Memorial Hospital is $186. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $258. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 21.99x the Medicare baseline. Located in 1320 West Main Street, Newark, OH.
Cash / Self-Pay
$258

Average discount available for prompt cash payment at this facility.

Insurance Median
$186

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: $258 (3050%)
Insurance Median: $186 (2199%)
Cash: $258 (3050% of Medicare)
Ins. Median: $186 (2199% 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 2199% of the Medicare baseline (a markup of 2099%). 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
Aetna $8 - $188 95%
Blue Cross Blue Shield $8 - $222 95%
Champva [500001] $8 95%
Cigna $8 - $233 95%
Humana $8 - $251 95%
Medicare (plans) $8 95%
Tricare $8 95%
UnitedHealthcare $8 - $220 95%
Veterans Administration [100068] $8 95%
Wellcare By Allwell [450104] $8 95%
Molina Marketplace [100106] $14 165%
Medical Mutual [100114] $142 - $215 1678%
Medben [700068] $181 - $253 2139%
Allied Benefit Systems [100015] $186 2199%
Geha [100039] $186 2199%
Gravie Administrative Services [100165] $186 2199%
Meritain [100063] $186 2199%
Optima [700069] $186 2199%
Trustmark Small Business Benefits [100263] $186 2199%
Webtpa [100127] $186 2199%
Benicomp [70090] $194 2293%
Consociate Health 6 Degrees [100059] $207 2447%
Consociate Health [100029] $207 2447%
Healthscope [100157] $220 2600%
Surest [100016] $220 2600%
United Medical Resources [700071] $220 2600%
American Postal Workers [100089] $233 2754%
Antidote Health Plan Of Ohio [70006803] $233 2754%
Coresource [100002] $233 - $258 2754%
Great West Life [700064] $233 2754%
National Association Of Letter Carriers [100067] $233 2754%
Ohio Healthy Luminare Health [100264] $233 2754%
Ohio Healthy [100255] $233 2754%
Ohio Ppo Connect [70006801] $233 2754%
Osu Prime Care [100254] $233 2754%
Quality Care Partners [70006802] $233 2754%
The Health Plan [100261] $233 2754%
Wellfleet Group, Llc [100164] $233 2754%
Coventry [100010] $239 2825%
Pan American Life [700070] $239 2825%
Ohio Health Choice [100109] $248 2931%
Administrative Concepts [100006] $251 2967%
Carefactor [100087] $251 2967%
Philadelphia American Life [100260] $251 - $258 2967%
Reliance Standard-Asrm [100258] $251 2967%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 West Main Street, Newark, OH 43055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals