Blood test, basic metabolic panel
Facility: Wichita County Health Center
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $82
- Cash Discount Price: $72
- vs. Medicare Baseline: 9.69x 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 969% of the Medicare baseline (a markup of 869%). 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 |
|---|---|---|
| Medicaid / KanCare | $74 | 875% |
| UnitedHealthcare | $90 | 1064% |
Consumer Guidance & Cost Commentary
For the blood test, basic metabolic panel (CPT 80048) at Wichita County Health Center in Leoti, Kansas, the facility's cash median rate is $72.00, which is lower than the negotiated rates of $74.00 paid by Medicaid/KanCare and $90.00 paid by UnitedHealthcare. While the facility is a government-owned Critical Access Hospital, patients with high-deductible plans may find paying cash directly more cost-effective than relying on insurance, as the negotiated rates exceed the cash price. However, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed before any insurance claim is processed.
It is important to note that commercial negotiated rates often include administrative overhead and do not represent the lowest possible price, whereas the Medicare benchmark for this service is $8.46. Comparing the facility's cash rate to the Medicare amount reveals a significant markup, highlighting that the true cost baseline is the federal government's fixed reimbursement rather than the hospital's gross charges. Consumers should avoid accepting summary bills that obscure individual line items and instead request a detailed, itemized audit to ensure no unbundled codes or services not rendered are included in the final invoice.