Blood test, basic metabolic panel
Facility: Ashland Health Center
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $30
- Cash Discount Price: $24
- 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 |
|---|---|---|
| Blue Cross Blue Shield | $10 | 118% |
| Compalliance-All Plans | $24 | 284% |
| Health Partners Of Kansas-All Plans | $26 | 307% |
| Multiplan-All Plans | $29 | 343% |
| Health Choice-All Plans | $30 | 355% |
| Medica Mcare - All Plans | $30 | 355% |
| Medicare (plans) | $30 | 355% |
| UnitedHealthcare | $30 | 355% |
| Healthy Blue Mcr Adv - All Other Plans | $30 | 355% |
| Aetna | $30 | 355% |
| Medicaid / KanCare | $30 | 355% |
| Providers Care (Wppa)-All Plans | $45 | 532% |
Consumer Guidance & Cost Commentary
For the CPT code 80048, representing a basic metabolic panel blood test at Ashland Health Center in Ashland, KS, the facility's cash median price is $24.00, which is lower than the state average of $28.00. While the facility's negotiated rates with major payers like Blue Cross Blue Shield and Medicaid/KanCare are set at $10 and $30 respectively, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying the cash rate of $24.00 directly. It is important to note that while the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should verify their specific plan details, as commercial negotiated rates can sometimes be higher than the cash price due to administrative costs and contract dynamics.
Patients should be aware that insurance billing can involve complex mechanisms such as balance billing or itemized audits, though the No Surprises Act provides federal protections against unexpected out-of-network charges for emergency care and non-emergency services at in-network facilities. If a patient receives a bill that seems inconsistent with the negotiated or cash rates listed above, they should request a full itemized CPT-coded statement to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies. Additionally, patients can often reduce their final cost by inquiring about prompt-pay discounts, which typically range from 20% to 50% off the billed amount for upfront payment, effectively bypassing the costly claims processing cycle that inflates insurance payments.