CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Astria Toppenish Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $15
  • Cash Discount Price: $142
  • vs. Medicare Baseline: 1.77x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Astria Toppenish Hospital is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $142. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 1.77x the Medicare baseline. Located in 502 W Fourth Ave, Toppenish, WA.
Cash / Self-Pay
$142

Average discount available for prompt cash payment at this facility.

Insurance Median
$15

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: $142 (1678%)
Insurance Median: $15 (177%)
Cash: $142 (1678% of Medicare)
Ins. Median: $15 (177% 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
Medicaid / KanCare $6 - $33 71%
Ambetter / Centene $7 83%
UnitedHealthcare $7 - $180 83%
Va $7 83%
Aetna $8 - $192 95%
Cigna $8 95%
Humana $8 - $218 95%
Li $8 95%
Medicare (plans) $8 - $180 95%
Molina $8 95%
Tricare $8 95%
Zenith $9 106%
Molina_Exchange $10 118%
Kaiser $32 378%
Regence $74 875%
Premera $82 969%
Premera_Affordable_Care $82 969%
Chpw_Cascade_Care $137 1619%
First_Choice $150 1773%
Tpsc $170 2009%
Bcchp $218 2577%
Great_Rivers $218 2577%
Healthcomp $218 2577%
Washington_State_Hca $218 2577%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 502 W Fourth Ave, Toppenish, WA 98948
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals