Blood test, basic metabolic panel
Facility: Rawlins County Health Center
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $61
- Cash Discount Price: $60
- vs. Medicare Baseline: 7.21x 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 721% of the Medicare baseline (a markup of 621%). 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 | $20 | 236% |
| UnitedHealthcare | $61 | 721% |
Consumer Guidance & Cost Commentary
For the basic metabolic panel blood test at Rawlins County Health Center in Atwood, Kansas, the cash price is $60.00, which is $10.00 lower than the facility's negotiated rate of $61.00. This cash price is also $11.54 less than the Medicare benchmark of $8.46, indicating a significant markup on the commercial side. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance rates often include administrative overhead that pushes the negotiated price higher than the cash option. If you have a high-deductible plan, paying the $60.00 cash price upfront might save you money compared to your insurance paying the negotiated rate, especially if your deductible has not yet been met.
To ensure you are getting the best possible price, it is important to verify your specific insurance plan's allowed amount before scheduling, as in-network rates can vary significantly between payers. Blue Cross Blue Shield and UnitedHealthcare both have negotiated rates of $61.00 for this service, which aligns with the facility's median negotiated rate. If you choose to pay out-of-pocket, ask the billing department about "self-pay" or "prompt-pay" discounts, which can further reduce the cost by bypassing the administrative fees associated with insurance claims. Always request a full itemized bill before paying to confirm that no unexpected charges or unbundled codes are included, and remember that the No Surprises Act protects you from balance billing for out-of-network services at in-network facilities.