CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Hospital of Univ of Pennsylvania

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $58
  • Cash Discount Price: $263
  • vs. Medicare Baseline: 6.86x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Hospital of Univ of Pennsylvania is $58. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $263. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 6.86x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$263

Average discount available for prompt cash payment at this facility.

Insurance Median
$58

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: $263 (3109%)
Insurance Median: $58 (686%)
Cash: $263 (3109% of Medicare)
Ins. Median: $58 (686% 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 686% of the Medicare baseline (a markup of 586%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Gspp And Wissahickon Hospice $4 47%
Cigna $5 - $118 59%
UnitedHealthcare $7 - $263 83%
Blue Cross Blue Shield $8 - $201 95%
Kaiser Permanente $8 - $263 95%
Medicare (plans) $8 - $9 95%
Philadelphia Va Medical Center $8 95%
Upmc $8 - $263 95%
Aetna $9 - $263 106%
Clover Health Plan $9 106%
Devoted Health $9 106%
Geisinger Health Plan $9 - $27 106%
Health Partners $9 - $263 106%
Humana $9 - $210 106%
Ibc $9 106%
Keystone First $9 106%
Medicaid / KanCare $9 - $263 106%
Pa Health And Wellness $9 - $14 106%
Pa Medical Assistance $9 - $263 106%
Penn Life (Living Independently For Elders) $9 106%
Tricare $9 106%
Us Family Health Plan $9 106%
Gateway Health Plan $10 118%
Elap $12 142%
Keystone Mercy Health Plan $12 - $263 142%
Ibc Commercial Hpn $13 154%
Claims Watcher $14 - $15 165%
Keystone Hmo Proactive $14 165%
Oscar Health Plan $14 165%
Centivo $15 177%
Elap Services $16 189%
Highmark $18 213%
Paired Kidney Exchange $21 248%
Penn Global Medicine $22 260%
Horizon Nj Health $44 - $46 520%
Preferred Health Care Eliance $58 686%
Pgm - Regie De L'Assurance Maladie Quebec $60 709%
Pgm - Kuwait Defense $92 - $118 1087%
Qualcare $100 1182%
Olympus $103 1217%
Coventry $105 - $134 1241%
Pgm - Chop $105 1241%
Wissahickon Hospice $105 1241%
Healthamerica/Coventry $118 - $129 1395%
First Health Global $132 1560%
Health Net $158 1868%
Pgm - Royal Embassy Of Saudi Arabia $158 1868%
Pgm - Embassy Of Qatar $171 2021%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $171 2021%
Interlink $176 2080%
Pgm - Embassy Of The United Emirates/Ipc $184 2175%
Health America/Ccn $210 2482%
Intergroup $210 2482%
Pgm - Kuwait Health Division $210 2482%
Pgm - Kuwait Oil $210 2482%
Preferred Care $210 2482%
Blue Quality Centers For Transplant (Bqct) $263 3109%
City Of Philadelphia Behavioral Health $263 3109%
Commercial Other $263 3109%
International Pfs $263 3109%
United Behavioral Health $263 3109%
Workers Compensation $263 3109%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals