Blood test, basic metabolic panel
Facility: Cheyenne County Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $27
- Cash Discount Price: $28
- vs. Medicare Baseline: 3.19x 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 319% of the Medicare baseline (a markup of 219%). 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 |
|---|---|---|
| UnitedHealthcare | $2 - $28 | 24% |
| Blue Cross Blue Shield | $19 | 225% |
| Tricare | $20 | 236% |
| Aetna | $20 - $27 | 236% |
| Healthy Blue Mcr Adv | $20 | 236% |
| First Health - All Plans | $20 | 236% |
| Choice Care - All Plans | $21 | 248% |
| Firstguard - All Plans | $23 | 272% |
| Wppa - All Plans | $26 | 307% |
| Cpm - All Plans | $27 | 319% |
| Preferred Hc - All Plans | $27 | 319% |
| Midlands Choice - All Plans | $28 | 331% |
| Childrens Mercy - All Plans | $28 | 331% |
| Health Partners - All Plans | $28 | 331% |
| Unicare - All Plans | $28 | 331% |
| Healthy Blue Mcaid - All Other Plans | $28 | 331% |
| Integrated Hp - All Plans | $28 | 331% |
| Ppo Next - All Plans | $28 | 331% |
| Healthwave Mcaid - All Plans | $28 | 331% |
| Providers Care-All Plans | $43 | 508% |
Consumer Guidance & Cost Commentary
For the CPT code 80048, representing a basic metabolic panel at Cheyenne County Hospital in St. Francis, KS, the cash price is $28.00, which matches the facility's negotiated median of $27.00 and the cash median of $28.00. This rate is significantly higher than the Medicare benchmark of $8.46, reflecting a markup typical of commercial pricing structures where negotiated rates often average 200% to 300% of the federal baseline. While commercial payers like UnitedHealthcare and Aetna have negotiated rates ranging from $19 to $43 depending on the specific plan, the cash price remains consistent. Patients with high-deductible plans may find paying the $28.00 cash rate directly more cost-effective than relying on insurance, as the negotiated rates for many commercial plans exceed the cash price, and the administrative overhead of claims processing can inflate the final allowed amount.
To minimize costs, patients should proactively ask the hospital about self-pay or prompt-pay discounts, which can reduce bills by 20% to 50% for upfront payment and bypass costly insurance billing cycles. Since the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, it may offer specific financial assistance programs not visible in standard billing data. It is important to note that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan's allowed amount before scheduling to avoid unexpected charges. Given that over 80% of hospital bills contain errors, consumers are encouraged to request a detailed, itemized statement if they receive a bill that