CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Clarion Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $16
  • Cash Discount Price: $52
  • vs. Medicare Baseline: 1.89x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Clarion Hospital is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $52. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 1.89x the Medicare baseline. Located in One Hospital Drive, Clarion, PA.
Cash / Self-Pay
$52

Average discount available for prompt cash payment at this facility.

Insurance Median
$16

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: $52 (615%)
Insurance Median: $16 (189%)
Cash: $52 (615% of Medicare)
Ins. Median: $16 (189% 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.

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
Amerihealth $8 - $10 95%
Cigna $8 - $46 95%
Highmark $8 - $32 95%
Highmark Community Blue $8 95%
Martin'S Point - Usfhp $8 - $33 95%
Medicare (plans) $8 95%
Tricare $8 95%
UnitedHealthcare $8 95%
Aetna $9 - $83 106%
American Health Plan $9 106%
Devoted Health Plan $9 - $37 106%
Gateway $9 - $34 106%
Geisinger $9 106%
Jefferson Health Plan $9 106%
Medicaid / KanCare $9 106%
Pa Health & Wellness $9 106%
The Health Plan $9 - $20 106%
Upmc $9 - $46 106%
Highmark - Ind.& Managed Care $19 - $32 225%
Peak Health $20 - $65 236%
Devon $70 827%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Drive, Clarion, PA 16214
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals