CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Adena Fayette Medical Center

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $26
Cash Discount Price: $20
vs. Medicare Baseline: 3.07x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Adena Fayette Medical Center is $26. 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 3.07x the Medicare baseline. Located in 1430 Columbus Avenue, Washington Ch, OH.

Cash / Self-Pay

$20

Average discount available for prompt cash payment at this facility.

Insurance Median

$26

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: $26 (307%)

Cash: $20 (236% of Medicare)

Ins. Median: $26 (307% 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 307% of the Medicare baseline (a markup of 207%). 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
Blue Cross Blue Shield	$3 - $27	35%
Aetna	$16 - $61	189%
Buckeye Community Health Plan	$16	189%
Humana	$16	189%
Medical Mutual Of Ohio	$16 - $30	189%
Medigold	$16	189%
Molina	$16	189%
Care Source	$17	201%
Molina Marketplace	$18	213%
United Medical Resources Ohcp	$25	296%
UnitedHealthcare	$25 - $26	296%
Cigna	$28	331%
Ohio Ppo Connect	$28	331%
The Health Plan	$28	331%
Care Source Just4Me	$30	355%
Medical Mutual Of Ohio Supermed	$30	355%
First Health	$32 - $61	378%
Ohio Health Choice	$32	378%
Multiplan/Private Healthcare Systems	$38	449%
Sidecar Health	$45	532%

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 Adena Fayette 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.