Blood test, basic metabolic panel
Facility: Pratt Regional Medical Center
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $41
- Cash Discount Price: $32
- vs. Medicare Baseline: 4.85x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 485% of the Medicare baseline (a markup of 385%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Christian Health Aid | $32 - $36 | 378% |
| UnitedHealthcare | $35 - $49 | 414% |
| Health Partners Of Kansas | $36 - $41 | 426% |
| Aetna | $38 - $43 | 449% |
| Choicecare | $42 - $48 | 496% |
Consumer Guidance & Cost Commentary
For the basic metabolic panel at Pratt Regional Medical Center in Pratt, KS, the cash price of $32.00 is notably lower than the facility's negotiated rates, which range from $32 to $49 depending on the insurance carrier. While the facility's cash rate is competitive, it is important to note that commercial negotiated rates often exceed cash prices due to administrative costs and contract structures; therefore, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance allowed amount is higher than the cash price. To secure the lowest possible rate, patients should explicitly ask for "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass the standard insurance billing cycle and eliminate administrative overhead.
This service is benchmarked against federal standards to ensure pricing transparency. The facility's cash rate of $32.00 is significantly lower than the Medicare amount of $8.46, which serves as the objective baseline for healthcare costs; however, commercial rates are typically marked up relative to this baseline. Patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, meaning they should not pay surprise bills out of fear of credit damage. If a patient receives an unexpected bill, they should request a formal, itemized audit to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors that can be corrected through written dispute with the billing supervisor.