Blood test, basic metabolic panel
Facility: Mcpherson Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $38
- Cash Discount Price: $33
- vs. Medicare Baseline: 4.49x 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 449% of the Medicare baseline (a markup of 349%). 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 |
|---|---|---|
| Tricare | $7 | 83% |
| UnitedHealthcare | $8 - $155 | 95% |
| Va Ccn - All Plans | $8 | 95% |
| Blue Cross Blue Shield | $8 | 95% |
| Humana | $8 | 95% |
| Wellcare Mcr Adv - All Plans | $8 | 95% |
| Healthy Blue Mcr Adv | $8 | 95% |
| Ambetter / Centene | $10 | 118% |
| Wppa - All Plans | $12 - $108 | 142% |
| Medical Associates - All Plans | $13 - $116 | 154% |
| Central Plains - All Plans | $13 - $116 | 154% |
| Christian Health Aid - All Plans | $14 - $124 | 165% |
| Aetna | $14 - $155 | 165% |
| Multiplan - All Plans | $15 - $140 | 177% |
| First Health - All Plans | $16 - $147 | 189% |
| Cigna | $16 - $147 | 189% |
| Health Partners - All Plans | $16 - $147 | 189% |
| Health Blue Mcaid - All Other Plans | $17 - $158 | 201% |
| Medicaid / KanCare | $17 - $155 | 201% |
Consumer Guidance & Cost Commentary
For this blood test at McPherson Hospital in Mcpherson, Kansas, the cash price is $33.00, which is lower than the facility's negotiated rates of $38.00 and the median paid amount of $36.00. While the facility's negotiated rate of $38.00 is slightly higher than the state average, patients with high-deductible plans might find paying the cash price of $33.00 more beneficial if their insurance negotiated rate exceeds this amount. It is important to note that commercial insurance rates often include administrative overhead and contract markups, making the cash price a potentially more efficient option for those who do not have active coverage or have met their deductible.
The Medicare benchmark for this service is $8.46, which serves as the objective baseline for evaluating pricing markups. Commercial rates, such as the facility's negotiated rate of $38.00, are significantly higher than this federal baseline, reflecting the typical markup found in commercial contracts. To minimize costs, patients should verify their specific plan's allowed amount before scheduling and ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront. Additionally, since over 80% of hospital bills contain errors, requesting a detailed, itemized statement is recommended to ensure no unbundled codes or services not rendered are included in the final charge.