CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Boone County Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $52
Cash Discount Price: $77
vs. Medicare Baseline: 6.15x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Boone County Hospital is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 6.15x the Medicare baseline. Located in 1015 Union Street, Boone, IA.

Cash / Self-Pay

$77

Average discount available for prompt cash payment at this facility.

Insurance Median

$52

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: $77 (910%)

Insurance Median: $52 (615%)

Cash: $77 (910% of Medicare)

Ins. Median: $52 (615% 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 615% of the Medicare baseline (a markup of 515%). 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
Va Ccn-All Plans	$1 - $15	12%
Aetna	$6 - $138	71%
Amerigroup Mcr Adv - All Other Plans	$6 - $73	71%
Choice Care Mcr Adv - All Plans	$6 - $73	71%
Humana	$6 - $160	71%
Iowa Hlth Adv - All Plans	$6 - $73	71%
Iowa Total Care Mcaid - All Plans	$6 - $81	71%
Medicaid / KanCare	$6 - $82	71%
Meridian Mcaid - All Plans	$6 - $80	71%
Mt Carmel Hp - All Plans	$6 - $73	71%
UnitedHealthcare	$6 - $104	71%
Tricare	$8	95%
Healthsmart Accell Network	$10 - $124	118%
Medical Associates Hp-All Plans	$10 - $133	118%
Healthsmart Ppo - All Other Plans	$11 - $142	130%
Health Alliance-All Plans	$13 - $160	154%
Midlands Choice-All Plans	$13 - $163	154%
Wellmark Hmo	$52	615%
Wellmark Ppo - All Other Plans	$57	674%
Mutually Preferred-All Plans	$169	1998%

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 $77.
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 Boone County 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.