Blood test, basic metabolic panel
Facility: Kansas City Orthopaedic Institute
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $30
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 3.55x 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 355% of the Medicare baseline (a markup of 255%). 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 |
|---|---|---|
| UnitedHealthcare | $8 - $53 | 95% |
| Cigna | $8 - $46 | 95% |
| Aetna | $8 | 95% |
| Blue Cross Blue Shield | $16 - $59 | 189% |
| Medica | $48 - $50 | 567% |
Consumer Guidance & Cost Commentary
For the CPT code 80048, representing a basic metabolic panel at Kansas City Orthopaedic Institute in Leawood, KS, the facility's negotiated rates range from $8 to $59 across five major payers, with a median negotiated payment of $30.00. This facility is owned by physicians and is located in an acute care hospital setting. While the data does not provide specific cash or median paid figures for this transaction, it is important to note that cash-pay options can sometimes be more cost-effective for patients with high-deductible plans if the insurance negotiated rate exceeds the cash price. Patients are encouraged to directly contact the hospital to inquire about "self-pay" or "prompt-pay" discounts, which can significantly reduce the final amount owed.
When evaluating the cost of this service, it is crucial to compare rates against objective benchmarks rather than the facility's inflated chargemaster list. The Medicare amount for this procedure is $8.46, which serves as a scientifically validated baseline for the true cost of delivery. Commercial negotiated rates often average 200% to 300% of Medicare, though fair pricing is typically defined as 120% to 150% of this rate. Additionally, patients should be aware of balance billing risks, particularly if receiving care from out-of-network providers or ancillary services, where the provider may bill the difference between their full charge and the insurance allowed amount. To protect against unexpected costs, patients should request a full itemized CPT-coded bill before paying and dispute any errors in writing rather than accepting summary invoices.