Blood test, basic metabolic panel
Facility: Stormont Vail Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $16
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.89x 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.
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 |
|---|---|---|
| Ambetter / Centene | $9 | 106% |
| UnitedHealthcare | $9 | 106% |
| Blue Cross Blue Shield | $9 - $20 | 106% |
Consumer Guidance & Cost Commentary
For the CPT code 80048, representing a basic metabolic panel at Stormont Vail Hospital in Topeka, KS, the median amount paid by insurers is $15,145.00, which is 1.9 times the Medicare benchmark rate of $8.46. This significant markup highlights the difference between the federal government's cost-based reimbursement and the commercial rates charged to patients. While the facility's negotiated rate is listed at $16.00, this figure likely reflects a specific plan tier rather than the average commercial rate, as commercial negotiated rates often average between 200% and 300% of the Medicare benchmark. It is important to note that cash-pay options are not available for this service, as the cash median is not reported; however, patients should always inquire about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can sometimes reduce costs significantly compared to standard insurance billing cycles.
When evaluating the financial impact of this procedure, patients should be aware that insurance billing involves complex administrative structures that can inflate the baseline price by 20% to 40% due to claims processing and contract management. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to verify that all ancillary services, such as lab draws, are covered under the same network agreement to avoid unexpected charges. Given that over 80% of hospital bills contain errors, consumers are advised to request a detailed, itemized bill that breaks down every CPT code and unit cost rather than accepting a summary invoice. If the final bill exceeds the expected negotiated amount, a formal