CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Prosser Memorial Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $129
Cash Discount Price: $89
vs. Medicare Baseline: 15.25x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Prosser Memorial Hospital is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $89. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 15.25x the Medicare baseline. Located in 723 Memorial Street, Prosser, WA.

Cash / Self-Pay

$89

Average discount available for prompt cash payment at this facility.

Insurance Median

$129

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: $89 (1052%)

Insurance Median: $129 (1525%)

Cash: $89 (1052% of Medicare)

Ins. Median: $129 (1525% 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 1525% of the Medicare baseline (a markup of 1425%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
UnitedHealthcare	$14 - $65	165%
Kaiser Permanente	$32 - $147	378%
Community Health Plan Of Washington	$34 - $65	402%
Coordinated Care	$34 - $65	402%
Amerigroup	$36 - $69	426%
Molina	$36 - $65	426%
Health Alliance Northwest	$40	473%
Wellcare	$40	473%
Humana	$41 - $137	485%
Aetna	$48 - $137	567%
Ambetter / Centene	$113 - $124	1336%
Asuris	$129 - $145	1525%
Health Management Adminstrators	$129 - $145	1525%
Premera	$129	1525%
Regence	$129 - $145	1525%
Cigna	$132	1560%
First Choice	$137	1619%
Multiplan	$137 - $145	1619%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $89.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80048.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Prosser Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 80048.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.