CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Sanford Vermillion Medical Center

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $72
  • Cash Discount Price: $82
  • vs. Medicare Baseline: 8.51x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Sanford Vermillion Medical Center is $72. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $82. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 8.51x the Medicare baseline. Located in 20 South Plum Street, Vermillion, SD.
Cash / Self-Pay
$82

Average discount available for prompt cash payment at this facility.

Insurance Median
$72

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: $82 (969%)
Insurance Median: $72 (851%)
Cash: $82 (969% of Medicare)
Ins. Median: $72 (851% 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 851% of the Medicare baseline (a markup of 751%). 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
Sanford Health Plan Align $30 355%
Wellmark Sd $31 366%
Ucare $33 - $90 390%
Aetna $34 - $89 402%
Health Partners $34 - $76 402%
Medicare (plans) $34 402%
Primewest $34 402%
UnitedHealthcare $34 - $85 402%
Sanford Health Plan $40 - $54 473%
Security Health Plan $56 662%
Medica $84 - $90 993%
Wellmark $88 - $89 1040%
First Choice Health Network $92 1087%
Healthez $92 1087%
Multiplan $92 1087%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 20 South Plum Street, Vermillion, SD 57069
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals