CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Othello Community Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $119
Cash Discount Price: $111
vs. Medicare Baseline: 14.07x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Othello Community Hospital is $119. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $111. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 14.07x the Medicare baseline. Located in 315 North 14Th Avenue, Othello, WA.

Cash / Self-Pay

$111

Average discount available for prompt cash payment at this facility.

Insurance Median

$119

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: $111 (1312%)

Insurance Median: $119 (1407%)

Cash: $111 (1312% of Medicare)

Ins. Median: $119 (1407% 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 1407% of the Medicare baseline (a markup of 1307%). 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
Ambetter / Centene	$63 - $64	745%
Amerigroup Mcaid	$63	745%
Chp Mcaid	$63	745%
Cocare - All Plans	$63	745%
Gau - All Plans	$63	745%
Kaiser - All Plans	$63	745%
Molina Mcaid	$63	745%
UnitedHealthcare	$63 - $148	745%
Chp - All Other Plans	$64	757%
Molina - All Other Plans	$64	757%
Medicare (plans)	$74	875%
Tricare	$97	1147%
Triwest - All Plans	$97	1147%
Asuris - All Plans	$119	1407%
Commercial Other - All Plans	$119	1407%
Hma - All Plans	$119	1407%
Hmso - All Plans	$119	1407%
Tpsc - All Plans	$119	1407%
Travelers - All Plans	$119	1407%
Veterans Admin - All Plans	$119	1407%
Blue Cross Blue Shield	$125	1478%
Cigna	$132	1560%
First Choice - All Plans	$134	1584%
Aetna	$140	1655%
Chp Mcr Adv	$148	1749%
Health Alliance Mcr Adv - All Plans	$148	1749%
Humana	$148	1749%
Molina Mcare	$148	1749%
Wellcare Mcr Adv - All Plans	$148	1749%

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 $111.
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 Othello Community 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.