CMS Price Transparency Data
Blood test, basic metabolic panel
Facility: Watsonville Community Hospital
Billing Code: 80048 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80048
- Insurance Median: $830
- Cash Discount Price: $902
- vs. Medicare Baseline: 98.11x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Watsonville Community Hospital is $830. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $902. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 98.11x the Medicare baseline. Located in 75 Nielson Street, Watsonville, CA.
Cash / Self-Pay
$902
Average discount available for prompt cash payment at this facility.
Insurance Median
$830
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: $902 (10662%)
Insurance Median: $830 (9811%)
Cash: $902 (10662% of Medicare)
Ins. Median: $830 (9811% 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 9811% of the Medicare baseline (a markup of 9711%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Fireman's Fund Work Comp | $8 | 95% |
| UnitedHealthcare | $8 - $902 | 95% |
| Travelers Insurance | $8 - $1,503 | 95% |
| Crawford & Co | $8 | 95% |
| Western Growers Work Comp | $8 | 95% |
| Workers Comp | $8 | 95% |
| Veterans Administration | $8 | 95% |
| Medicare (plans) | $8 | 95% |
| Beta Healthcare Group | $8 | 95% |
| Health Net of California | $8 - $943 | 95% |
| Nx Health Network | $8 | 95% |
| Hartford Workers' Comp | $8 | 95% |
| Tricare | $8 | 95% |
| Kemper Group Workers Comp | $8 | 95% |
| Blue Shield PPO | $8 - $27 | 95% |
| Republic Idemnity W/Comp | $8 | 95% |
| Ace-Usa | $8 | 95% |
| Alignment Health Plan | $8 | 95% |
| Keenan & Assoc Work Comp | $8 | 95% |
| U.S. Dept. of Labor | $8 | 95% |
| Liberty Mutual Work Comp | $8 | 95% |
| Miscellaneous Work Comp | $8 | 95% |
| Secure Horizons Dign HMO | $8 - $301 | 95% |
| Gallagher Bassett Svcs | $8 | 95% |
| Fleming & Associates | $8 | 95% |
| Pinnacle Healthcare Uc | $8 | 95% |
| Secure Horizons | $8 | 95% |
| Well Path | $10 - $1,503 | 118% |
| Healthy Families | $10 - $27 | 118% |
| Medi-Cal/Eds | $10 | 118% |
| Medi-Cal E.R. | $10 | 118% |
| Ccs/Monterey County | $10 | 118% |
| California Childrens Srvs | $10 | 118% |
| Medicaid / KanCare | $10 | 118% |
| Alliance/Sccho | $11 | 130% |
| Aetna | $12 - $1,233 | 142% |
| Pacificare HMO | $12 - $902 | 142% |
| Great-West/Phcs | $12 - $1,052 | 142% |
| Health Net Pmg HMO | $12 - $943 | 142% |
| Cigna | $12 - $1,052 | 142% |
| Blue Cross Blue Shield | $12 - $1,339 | 142% |
| Blue Shield HMO | $12 - $301 | 142% |
| Ufcw/Valley Clerks | $27 | 319% |
| United Agriculture | $27 | 319% |
| Bs Employee | $27 | 319% |
| Sheet Metal Workers | $56 - $1,339 | 662% |
| State Compensation Fund | $56 - $1,339 | 662% |
| Operating Engineers | $56 - $1,339 | 662% |
| Monterey Bay Pub Emp Trst | $56 - $1,339 | 662% |
| Laborers Health & Welfare | $56 - $1,339 | 662% |
| City of Wats/Pinnacle Clm | $56 - $1,339 | 662% |
| Western Growers Trust/Bc | $56 - $1,339 | 662% |
| Teamsters Benefit Trust | $56 - $1,339 | 662% |
| Claims Management Wc | $56 - $1,339 | 662% |
| Carpenters H&W Trust | $56 - $1,339 | 662% |
| Calif Ironworkers Field | $56 - $1,339 | 662% |
| Robert Kennedy/Ccn | $56 - $1,339 | 662% |
| Pinnacle Claims Tpa/Bc | $56 - $1,339 | 662% |
| Delta Health Systems | $56 - $1,339 | 662% |
| Victim Compensation Plan | $271 - $1,503 | 3203% |
| Medicruz | $271 | 3203% |
| Western Health Advantage | $752 | 8889% |
| Self Pay | $902 | 10662% |
| Pacificare PPO | $902 | 10662% |
| Health Net Smartcare Netw | $902 | 10662% |
| Health Net Canopycare HMO | $943 | 11147% |
| Health Net Blue and Gold | $943 | 11147% |
| Geha (Ccn) | $1,052 - $1,203 | 12435% |
| First Health | $1,052 - $1,203 | 12435% |
| Adventist Risk Management | $1,052 - $1,203 | 12435% |
| Transwestern | $1,052 - $1,203 | 12435% |
| Private Healthcare System | $1,173 | 13865% |
| Multiplan Inc PPO | $1,173 | 13865% |
| Coastal Healthcare Admin | $1,278 - $1,353 | 15106% |
| Salinas Valley Mem Hops | $1,278 | 15106% |
| Physicians Mutual | $1,503 | 17766% |
| Zenith National Ins | $1,503 | 17766% |
| Farmers Insurance | $1,503 | 17766% |
| Allstate | $1,503 | 17766% |
| Sutter Health Plus | $1,503 | 17766% |
| Wholesale Beer Distributo | $1,503 | 17766% |
| Prucare Pmg HMO | $1,503 | 17766% |
| State Farm Ins | $1,503 | 17766% |
| Aaa | $1,503 | 17766% |
| Apwu Health Plan | $1,503 | 17766% |
| Miscellaneous Auto | $1,503 | 17766% |
| Miscellaneous Insurance | $1,503 | 17766% |
| Aarp | $1,503 | 17766% |
| Prucare Pmg POS | $1,503 | 17766% |
| North Calif Bakery Driver | $1,503 | 17766% |
| United Administrative | $1,503 | 17766% |
| Humana | $1,503 | 17766% |
| Bankers Life & Casualty | $1,503 | 17766% |