CMS Price Transparency Data
Blood test, basic metabolic panel
Facility: Saint Alphonsus Medical Center Ontario
Billing Code: 80048 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80048
- Insurance Median: $21
- Cash Discount Price: $46
- vs. Medicare Baseline: 2.48x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Saint Alphonsus Medical Center Ontario is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 2.48x the Medicare baseline. Located in 351 Sw 9Th Street, Ontario, OR.
Cash / Self-Pay
$46
Average discount available for prompt cash payment at this facility.
Insurance Median
$21
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: $46 (544%)
Insurance Median: $21 (248%)
Cash: $46 (544% of Medicare)
Ins. Median: $21 (248% 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 248% of the Medicare baseline (a markup of 148%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $6 - $21 | 71% |
| Blue Cross Blue Shield | $8 - $60 | 95% |
| Medicare (plans) | $8 - $9 | 95% |
| UnitedHealthcare | $8 - $67 | 95% |
| Aetna | $9 - $66 | 106% |
| American Health Advantage Of Idaho | $9 | 106% |
| Healthnet | $9 | 106% |
| Healthcare Management Admin | $14 | 165% |
| Blue Benefit Administrators Of Massachusetts | $15 | 177% |
| Blue Care Network | $15 | 177% |
| Blue Distinction Transplant | $15 | 177% |
| Blue Shield - Ca | $15 | 177% |
| Blue Shield - Id (Regence) | $15 | 177% |
| Blue Shield - Ny Highmark Northeastern | $15 | 177% |
| Blue Shield - Ny Highmark Western | $15 | 177% |
| Blue Shield - Pa (Highmark) | $15 | 177% |
| Blue Shield - Wa (Regence) | $15 | 177% |
| Moda Health | $16 - $68 | 189% |
| Ada County Jail Inmate Ins | $21 | 248% |
| Ambetter / Centene | $21 | 248% |
| Amish Mennonite | $21 | 248% |
| Bcccp-Michigan | $21 | 248% |
| Bccp | $21 | 248% |
| Bmc Healthnet | $21 | 248% |
| Breast Grant-Connecticut | $21 | 248% |
| California Health And Wellness | $21 | 248% |
| Cardinal Innovations Lme | $21 | 248% |
| Care Oregon Ohp | $21 | 248% |
| Cencal Health Plan | $21 | 248% |
| Cenpatico | $21 | 248% |
| Centurion Of Idaho | $21 | 248% |
| Chhuny | $21 | 248% |
| Childrens Comm Health Plan | $21 | 248% |
| Childrens Medical Services Title 19 | $21 | 248% |
| Cigna | $21 - $66 | 248% |
| Community Benefit Health | $21 | 248% |
| Community Care Behavorial Health | $21 | 248% |
| Community Health Choice | $21 | 248% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $21 | 248% |
| Dean Wi Badgercare | $21 | 248% |
| Delaware First Health | $21 | 248% |
| Delta Dental Nj | $21 | 248% |
| Dph Tb Program | $21 | 248% |
| Dscc | $21 | 248% |
| Eastpointe Lme | $21 | 248% |
| Family Health Network | $21 | 248% |
| Freedom First Healthcare | $21 | 248% |
| Ghc Scw Wi Badgercare | $21 | 248% |
| Harbor Health | $21 | 248% |
| Health Safety Net | $21 | 248% |
| Healthy Blue Ne | $21 | 248% |
| Hennepin Health | $21 | 248% |
| Humana | $21 - $62 | 248% |
| Id County Ada | $21 | 248% |
| Id County Canyon | $21 | 248% |
| Id County Cat Fund | $21 | 248% |
| Id County Payette | $21 | 248% |
| Idaho Womens Health Check | $21 | 248% |
| Indiana Breast Cervical Cancer | $21 | 248% |
| Inland Empire Health Plan | $21 | 248% |
| Intercommunity Health Ohp | $21 | 248% |
| Iowa Total Care | $21 | 248% |
| Jai Medical System | $21 | 248% |
| Kern Family Health Plan | $21 | 248% |
| Keystone First | $21 | 248% |
| Keystone First Chip | $21 | 248% |
| La Care Health Plan | $21 | 248% |
| Lakeland Care Inc | $21 | 248% |
| Managed Health Services - Indiana | $21 | 248% |
| Maryland Breast & Cervical Program | $21 | 248% |
| Maryland Healthy Smiles - Scion Dental | $21 | 248% |
| Maryland Physicians Care | $21 | 248% |
| Massachusetts Behavioral Health Partnership | $21 | 248% |
| Mdwise | $21 | 248% |
| Medi-Cal | $21 | 248% |
| Medi-Cal Healthnet | $21 | 248% |
| Medstar Dc Healthy Family | $21 | 248% |
| Medstar Md Health Choice | $21 | 248% |
| Mo Home State Health Plan | $21 | 248% |
| Molina Centennial Care | $21 | 248% |
| Nascentia Health Options | $21 | 248% |
| Nebraska Total Care | $21 | 248% |
| New York Cancer Services Program | $21 | 248% |
| Nextlevel Health | $21 | 248% |
| Oregon Screenwise | $21 | 248% |
| Pace Of Southwest Michigan | $21 | 248% |
| Paramount Advantage | $21 | 248% |
| Parkland Community Health Plan | $21 | 248% |
| Partners Behavioral Lme | $21 | 248% |
| Peach State Healthplan | $21 | 248% |
| Presbyterian Centennial Care | $21 | 248% |
| Prestige Health Choice | $21 | 248% |
| Priority Partners | $21 | 248% |
| Rx 340B Pass Along | $21 | 248% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $21 | 248% |
| Rx Medi-Cal | $21 | 248% |
| Rx Meridian Rx | $21 | 248% |
| Sandhills Center Lme | $21 | 248% |
| Screening For Life | $21 | 248% |
| Sunshine State Health Plan | $21 | 248% |
| Superior Health | $21 | 248% |
| Tenncare | $21 | 248% |
| Texas Children'S Health Plan | $21 | 248% |
| Trillium Community Ohp | $21 | 248% |
| Tufts Health Public Plans | $21 | 248% |
| Vaya Health Lme | $21 | 248% |
| Wellsense Health Plan | $21 | 248% |
| Wi Womens Wellness | $21 | 248% |
| Webtpa | $22 - $63 | 260% |
| Selecthealth | $32 - $63 | 378% |
| Mountain Health Co-Op | $42 | 496% |
| Pacificsource Health Plans | $42 - $66 | 496% |
| Allegiance | $53 | 626% |
| Correctional Health Partners | $55 | 650% |
| Columbia Health Network | $56 | 662% |
| Allied National Global Care | $63 | 745% |
| Asrm - Reliance Standard Life Insurance | $63 | 745% |
| Christian Care Ministry | $63 | 745% |
| Dean Health | $63 | 745% |
| Fallon Health | $63 | 745% |
| Family Life Insurance Company | $63 | 745% |
| First Choice Health | $63 | 745% |
| Ghc Scw | $63 | 745% |
| International Benefit Administrators | $63 | 745% |
| Lifetime Benefit Solutions | $63 | 745% |
| Manhattan Life | $63 | 745% |
| Pai | $63 | 745% |
| Pan-American Life | $63 | 745% |
| Paramount Hmo | $63 | 745% |
| Phcs | $63 | 745% |
| Trinity Health Share | $63 | 745% |
| Lifewise | $65 | 768% |
| Allied Benefit Systems | $66 | 780% |
| Ameriben | $66 | 780% |
| Asr Health Benefits | $66 | 780% |
| Christian Brother Services | $66 | 780% |
| First Health | $66 | 780% |
| Geha | $66 - $67 | 780% |
| Healthez | $66 | 780% |
| Luminare Health (Detroit) | $66 | 780% |
| Medi Share | $66 | 780% |
| Priority Health | $66 | 780% |
| Providence | $66 | 780% |
| Rural Carrier Health Benefit Plan | $66 | 780% |