Blood test, basic metabolic panel
Facility: Centura St. Catherine-Dodge City
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $379
- Cash Discount Price: $231
- vs. Medicare Baseline: 44.80x 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 4480% of the Medicare baseline (a markup of 4380%). 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 |
|---|---|---|
| Kaiser | $8 | 95% |
| Medicare (plans) | $8 | 95% |
| Cigna | $8 | 95% |
| Kansas Health | $8 | 95% |
| Aetna | $8 - $461 | 95% |
| Humana | $8 | 95% |
| Blue Cross Blue Shield | $8 - $23 | 95% |
| Centura Employee Plan | $11 | 130% |
| UnitedHealthcare | $379 | 4480% |
| Wpaa | $403 | 4764% |
| Multiplan | $461 - $519 | 5449% |
| Christian Health Aid | $461 | 5449% |
| Health Partners Of Kansas | $519 | 6135% |
Consumer Guidance & Cost Commentary
For the basic metabolic panel blood test at Centura St. Catherine-Dodge City, the cash price of $231.00 is significantly lower than the facility's negotiated rates, which range from $8 to $519 depending on the insurance carrier. While the facility's median negotiated rate of $379.00 exceeds the cash price, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance allows a higher amount than the cash rate. It is important to note that the facility's cash price of $231.00 is higher than the state of Kansas average for this service, suggesting that paying cash directly may not always result in the lowest possible cost compared to regional averages.
The Medicare benchmark for this procedure is $8.46, which serves as a baseline for evaluating the facility's pricing markup. The facility's gross charge of $576.00 is substantially higher than the Medicare rate, illustrating the typical administrative and profit margins built into commercial billing. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, it is still advisable to request an itemized bill to verify that all charges are accurate and that no unbundled codes or services not rendered have been included. Additionally, patients should inquire about prompt-pay discounts before scheduling, as paying in full upfront can sometimes reduce the final amount owed.