CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: St Joseph's Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $195
  • Cash Discount Price: $234
  • vs. Medicare Baseline: 23.05x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at St Joseph's Hospital is $195. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $234. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 23.05x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$234

Average discount available for prompt cash payment at this facility.

Insurance Median
$195

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: $234 (2766%)
Insurance Median: $195 (2305%)
Cash: $234 (2766% of Medicare)
Ins. Median: $195 (2305% 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 2305% of the Medicare baseline (a markup of 2205%). 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.

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
Illinois Breast and Cervical Cancer Program $8 95%
Molina Healthcare $15 - $65 177%
Meridian Health Plan $15 177%
UnitedHealthcare $17 - $325 201%
Caterpillar, Inc. $17 201%
Cigna $20 236%
Aetna $65 - $227 768%
Blue Cross Blue Shield $65 768%
Humana $65 768%
Sae Hospice $65 768%
Clear Spring Health of Illinois $65 768%
Amish Community $91 1076%
Naphcare $136 1608%
Celtic Insurance Company $143 1690%
Hopetrust $162 1915%
Claim Doc $162 1915%
Wellfirst $208 2459%
First Health $240 2837%
Multiplan/Phcs $276 3262%
Healthlink $276 3262%
Healthcare Finest Network (Hfn) $292 3452%
Provider Network of America $292 3452%
Health Alliance Medical Plans $325 3842%
Healthscope $325 3842%
Current Health Solutions $325 3842%
Consociate Group $325 3842%
Qtc Medical Group of Illinois $325 3842%
Interplan $325 3842%
Mental Health Network $325 3842%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals