Blood test, basic metabolic panel
Facility: Kansas Spine & Specialty Hospital, Llc
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $8
- Cash Discount Price: $62
- vs. Medicare Baseline: 0.95x 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 |
|---|---|---|
| Humana | $8 | 95% |
| UnitedHealthcare | $8 - $10 | 95% |
| Providrs Care Network | $8 | 95% |
| United Mine Workers Of America | $8 | 95% |
| Aetna | $8 - $11 | 95% |
| Blue Cross Blue Shield | $8 | 95% |
| Lantern Specialty Care | $14 | 165% |
Consumer Guidance & Cost Commentary
For the CPT code 80048 (Blood test, basic metabolic panel) at Kansas Spine & Specialty Hospital, Llc, the cash median price is $62.00, which is significantly lower than the facility's gross charge of $95.00. While the facility is owned by a physician and located in Wichita, KS, the data does not provide specific county or state average figures for comparison. However, the cash price of $62.00 is notably higher than the Medicare benchmark of $8.46, illustrating that commercial cash rates often exceed federal reimbursement standards. Patients with high-deductible plans may find this cash rate advantageous if their insurance negotiated rates exceed $62.00, as paying out-of-pocket could result in immediate savings compared to the administrative costs and potential balance billing associated with insurance claims.
The median amount paid by insurance payers for this service is $22.00, which is substantially lower than the cash price, reflecting the impact of negotiated contracts. Seven payers, including Humana, UnitedHealthcare, and Aetna, have contracts with the facility, though the data indicates the facility is classified as "Physician" owned rather than a standard Acute Care Hospital. It is important to note that while the No Surprises Act protects patients from balance billing for emergency services at in-network facilities, patients should still verify their specific plan details before scheduling. To minimize costs, consumers are encouraged to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the $62.00 cash median by 20% to 50% if paid in full upfront, bypassing the lengthy