CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Pennsylvania Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $158
  • Cash Discount Price: $460
  • vs. Medicare Baseline: 18.68x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Pennsylvania Hospital is $158. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $460. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 18.68x the Medicare baseline. Located in 800 Spruce Street, Philadelphia, PA.
Cash / Self-Pay
$460

Average discount available for prompt cash payment at this facility.

Insurance Median
$158

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: $460 (5437%)
Insurance Median: $158 (1868%)
Cash: $460 (5437% of Medicare)
Ins. Median: $158 (1868% 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 1868% of the Medicare baseline (a markup of 1768%). 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
Cigna $5 - $156 59%
Blue Cross Blue Shield $8 - $460 95%
Medicare (plans) $8 - $9 95%
Philadelphia Va Medical Center $8 95%
Upmc $8 - $460 95%
Aetna $9 - $460 106%
Clover Health Plan $9 106%
Gateway Health Plan $9 - $10 106%
Geisinger Health Plan $9 - $27 106%
Health Partners $9 - $460 106%
Humana $9 - $368 106%
Ibc $9 106%
Keystone First $9 106%
Medicaid / KanCare $9 - $460 106%
Pa Health And Wellness $9 - $14 106%
Pa Medical Assistance $9 106%
Penn Life (Living Independently For Elders) $9 106%
Tricare $9 106%
UnitedHealthcare $9 - $460 106%
Us Family Health Plan $9 106%
Elap $12 142%
Keystone Mercy Health Plan $12 142%
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%
Penn Global Medicine $22 260%
Horizon Nj Health $78 - $81 922%
Pgm - Regie De L'Assurance Maladie Quebec $106 1253%
Preferred Health Care Eliance $120 1418%
Pgm - Kuwait Defense $161 - $207 1903%
Devon $175 - $207 2069%
Qualcare $175 2069%
Coventry $184 - $235 2175%
Pgm - Chop $184 2175%
Wissahickon Hospice $184 2175%
Healthamerica/Coventry $207 - $225 2447%
Olympus $224 2648%
First Health Global $230 2719%
Urn-Cancer Resource Services $230 2719%
Health Net $276 3262%
Pgm - Royal Embassy Of Saudi Arabia $276 3262%
Pgm - Embassy Of Qatar $299 3534%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $299 3534%
Pgm - Embassy Of The United Emirates/Ipc $322 3806%
Devon Health Services Inc $368 4350%
Health America/Ccn $368 4350%
Intergroup $368 4350%
Pgm - Kuwait Health Division $368 4350%
Pgm - Kuwait Oil $368 4350%
Preferred Care $368 4350%
Commercial Other $460 5437%
Community Behavioral Health $460 5437%
International Pfs $460 5437%
Quest Behavioral Health $460 5437%
United Behavioral Health $460 5437%
Workers Compensation $460 5437%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals