CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Nationwide Children's Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $99
Cash Discount Price: $110
vs. Medicare Baseline: 11.70x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Nationwide Children's Hospital is $99. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $110. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 11.70x the Medicare baseline. Located in 700 Children's Drive, Columbus, OH.

Cash / Self-Pay

$110

Average discount available for prompt cash payment at this facility.

Insurance Median

$99

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: $110 (1300%)

Insurance Median: $99 (1170%)

Cash: $110 (1300% of Medicare)

Ins. Median: $99 (1170% 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 1170% of the Medicare baseline (a markup of 1070%). 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	$25 - $132	296%
Amerihealth	$30	355%
Bchp	$30	355%
Caresource	$30 - $66	355%
Humana	$30 - $133	355%
Molina	$30	355%
UnitedHealthcare	$30 - $133	355%
Mmo	$89 - $120	1052%
Aetna	$94 - $133	1111%
Ohg	$94 - $126	1111%
Ohio Ppo Connect	$95 - $130	1123%
Osu	$95 - $130	1123%
Ohc	$97 - $130	1147%
Ahpo	$98 - $132	1158%
Cigna	$98 - $132	1158%
Front Path Health Coalition	$98 - $132	1158%
Unicare	$99 - $133	1170%
The Health Plan	$100 - $134	1182%
Emerald Health	$102 - $137	1206%
First Health	$102 - $137	1206%
Phcs	$102 - $137	1206%

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 $110.
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 Nationwide Children's Hospital 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.