Blood test, basic metabolic panel
Facility: Lmh
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $9
- Cash Discount Price: $56
- vs. Medicare Baseline: 1.06x 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 |
|---|---|---|
| Medicare (plans) | $8 | 95% |
| Cigna | $8 - $149 | 95% |
| Blue Cross Blue Shield | $8 - $144 | 95% |
| Haskell Indian Health Services | $8 | 95% |
| UnitedHealthcare | $8 - $46 | 95% |
| Humana | $8 | 95% |
| Aetna | $9 - $185 | 106% |
| Allwell | $9 | 106% |
| Ambetter / Centene | $13 | 154% |
| Non Contracted | $178 | 2104% |
| First Health | $207 | 2447% |
Consumer Guidance & Cost Commentary
For this basic metabolic panel test at Lmh in Lawrence, KS, the cash price of $56.00 is significantly lower than the facility's gross charge of $223.00. While the facility's negotiated rates with major payers like Cigna and Blue Cross Blue Shield range from $8 to $149, the cash rate remains the most transparent figure for patients without insurance. It is important to note that for individuals with high-deductible plans, paying the cash price upfront can sometimes be more cost-effective than relying on insurance, as the negotiated rates often exceed the cash price due to administrative overhead. Patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the final amount owed.
The facility's pricing is evaluated against federal benchmarks to ensure fairness. The Medicare reimbursement rate for this service is $8.46, and the facility's cash rate of $56.00 represents a markup of 1.1 times the Medicare amount. This comparison highlights that while commercial negotiated rates vary widely across different insurers, the cash price provides a clear baseline for out-of-pocket costs. Given that over 80% of hospital bills contain errors, patients should request a detailed, itemized statement rather than accepting a summary bill. If any charges appear incorrect, such as unbundled components or services not rendered, a formal written dispute should be sent to the billing supervisor to protect against unexpected balance billing or double-charging.