Blood test, basic metabolic panel
Facility: Ellinwood District Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $33
- Cash Discount Price: $41
- vs. Medicare Baseline: 3.90x 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 390% of the Medicare baseline (a markup of 290%). 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 |
|---|---|---|
| Humana | $33 | 390% |
| Cigna | $33 | 390% |
| Aetna | $33 | 390% |
| Blue Cross Blue Shield | $33 | 390% |
| UnitedHealthcare | $33 | 390% |
Consumer Guidance & Cost Commentary
For this basic metabolic panel test at Ellinwood District Hospital, the cash price of $41.00 is lower than the facility's negotiated rate of $33.00, which is the amount commercial payers like Humana and Cigna agreed to pay. While the facility is a Critical Access Hospital in Kansas, the data does not provide specific county or state average benchmarks for this procedure, so a direct comparison to regional pricing is not available in this report. However, the cash price remains a key reference point for patients with high-deductible plans or those without insurance, as paying out-of-pocket can sometimes be more cost-effective than using insurance when the negotiated rate exceeds the cash price.
The Medicare benchmark for this service is $8.46, which serves as the objective baseline for evaluating pricing markups. The facility's cash rate of $41.00 represents a significant markup over the Medicare amount, reflecting the administrative costs and profit margins inherent in commercial billing. Patients should be aware that while the facility is owned by a Government Hospital District, the billing structure follows standard commercial principles where prompt-pay discounts may be available if paid in full upfront. To ensure you are receiving the most accurate pricing, always request an itemized bill before payment to verify that all charges are correct and that no unbundled codes or services not rendered have been included.