CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Mercy Hospital Pittsburg, Inc

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $14
  • Cash Discount Price: $100
  • vs. Medicare Baseline: 1.65x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Mercy Hospital Pittsburg, Inc is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $100. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 1.65x the Medicare baseline. Located in 1 Mt Carmel Way, Pittsburg, KS.
Cash / Self-Pay
$100

Average discount available for prompt cash payment at this facility.

Insurance Median
$14

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: $100 (1182%)
Insurance Median: $14 (165%)
Cash: $100 (1182% of Medicare)
Ins. Median: $14 (165% 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.

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
Aetna $8 - $131 95%
Pace Of The Ozarks Contracted [320518] $8 95%
Kindful Hospice Contracted [320434] $8 95%
Blue Cross Blue Shield $8 - $24 95%
Halo Hcr Inc Hospice Contracted [320432] $8 95%
Medicaid / KanCare $8 - $14 95%
Mercy Hospice Okc [20252] $8 95%
UnitedHealthcare $8 - $104 95%
Humana $8 95%
Halo Hcr Inc Hospice [20432] $8 95%
Cross Timbers Hospice [20098] $8 95%
Tricare $8 95%
Medicare (plans) $8 95%
Dept Of Veteran Affairs Contracted [320106] $8 95%
Medica Contracted [320239] $8 95%
Elara Caring Aspire Hospice [20433] $8 95%
Kindful Hospice [20434] $8 95%
American Health Advantage Of Ks Mcr Contracted [320508] $9 106%
Health Choice Contracted [320166] $11 130%
Ambetter / Centene $14 165%
Home State Health Plan Contracted [320187] $14 165%
Providrs Care Network Contracted [320484] $16 189%
Cigna $47 - $48 556%
United Medical Resources Contracted [320454] $104 1229%
Imagine 360 Contracted [320494] $123 1454%
Healthlink Contracted [320179] $123 1454%
American Healthcare Alliance Contracted [320020] $123 1454%
Reflect Health Contracted [320492] $123 1454%
Edison Health Solutions Contracted [320502] $123 1454%
Auxiant Contracted [320462] $123 1454%
Ebms Contracted [320493] $123 1454%
Yuzu Health Contracted [320521] $123 1454%
Workers Comp [20426] $123 1454%
Mercy Benefit Admin Contracted [320251] $123 1454%
Aither Health Contracted [320449] $123 1454%
First Health Contracted [320128] $131 1548%

Consumer Guidance & Cost Commentary

For this blood test, basic metabolic panel, Mercy Hospital Pittsburg, Inc. lists a cash price of $100.00, which is notably lower than the facility's negotiated rates with most insurance carriers. While the hospital's cash rate is significantly below its gross charge of $154.00, patients should be aware that many commercial payers, including UnitedHealthcare and Aetna, negotiate rates that can exceed the cash price due to administrative overhead and contract structures. If you have a high-deductible plan or have not yet met your deductible, paying the cash price of $100.00 upfront may result in lower out-of-pocket costs compared to the insurance negotiated rate, provided you can afford the immediate payment. We recommend contacting the hospital directly to confirm their "self-pay" or "prompt-pay" discount policies before scheduling, as these upfront incentives can further reduce your financial burden.

The facility's pricing for this service is benchmarked against the Medicare rate of $8.46, which serves as a scientifically validated baseline for healthcare costs. The cash price of $100.00 represents a markup of 1.7 times the Medicare amount, while the median negotiated rate across all payers is $14.00. It is important to note that while commercial negotiated rates often average 200% to 300% of Medicare, fair pricing is typically defined as 120% to 150% of the Medicare rate. If you receive an itemized bill that includes charges for services not rendered, unbundled components, or errors, you have the right to request a formal itemized billing audit to identify and correct these discrepancies

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Mt Carmel Way, Pittsburg, KS 66762
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals