CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Unitypoint Health - Meriter

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $55
Cash Discount Price: $147
vs. Medicare Baseline: 6.50x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Unitypoint Health - Meriter is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $147. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 6.50x the Medicare baseline. Located in 202 S Park St, Madison, WI.

Cash / Self-Pay

$147

Average discount available for prompt cash payment at this facility.

Insurance Median

$55

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: $147 (1738%)

Insurance Median: $55 (650%)

Cash: $147 (1738% of Medicare)

Ins. Median: $55 (650% 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 650% of the Medicare baseline (a markup of 550%). 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	$5 - $76	59%
Aspirus	$8 - $110	95%
Blue Cross Blue Shield	$8 - $174	95%
Humana	$8	95%
Illinicare	$8	95%
Meridiancare	$8	95%
Prevea 360	$8 - $156	95%
Wellmark Uph Self-Funded	$8 - $106	95%
Health Partners Open Network	$13 - $67	154%
Cigna	$44 - $55	520%
Security Health Plan	$47 - $57	556%
Mercy Care	$55 - $61	650%
Quartz	$57	674%
Medical Associates Health Plan	$58 - $66	686%

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 $147.
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 Unitypoint Health - Meriter 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.