CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Nationwide Children's Hospital Toledo, LLC

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $25
Cash Discount Price: $225
vs. Medicare Baseline: 2.96x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Nationwide Children's Hospital Toledo, LLC is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $225. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 2.96x the Medicare baseline. Located in 2213 Cherry Street, Toledo, OH.

Cash / Self-Pay

$225

Average discount available for prompt cash payment at this facility.

Insurance Median

$25

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: $225 (2660%)

Insurance Median: $25 (296%)

Cash: $225 (2660% of Medicare)

Ins. Median: $25 (296% 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 296% of the Medicare baseline (a markup of 196%). 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
Caresource	$8 - $9	95%
Molina	$8 - $22	95%
Mcclaren Health Plan - Michigan	$9	106%
Cigna	$13	154%
Amerihealth	$22	260%
Bchp	$22	260%
Blue Cross Blue Shield	$22 - $191	260%
Humana	$22	260%
UnitedHealthcare	$22 - $189	260%
Front Path Health Coalition	$25 - $169	296%
Mmo	$94 - $131	1111%
Aetna	$144	1702%
Mcclaren Health Plan	$169	1998%
Ohc	$188	2222%
Ohio Ppo Connect	$188	2222%
First Health	$289	3416%

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 $225.
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 Toledo, LLC 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.