Blood test, basic metabolic panel
Facility: Rooks County Health Center
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $30
- Cash Discount Price: $25
- 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 |
|---|---|---|
| Veterans Admin - All Plans | $3 | 35% |
| Tricare | $16 | 189% |
| Celtic Mcr Adv | $16 | 189% |
| Celtic Comm - All Other Plans | $17 | 201% |
| Blue Cross Blue Shield | $20 | 236% |
| UnitedHealthcare | $30 | 355% |
| Aetna | $30 | 355% |
| Preferred Benefits Admin | $30 | 355% |
| Preferred Hlthcare - All Other Plans | $32 | 378% |
| Health Partners - All Plans | $32 | 378% |
| Healthy Blue Mcaid - All Plans | $34 | 402% |
Consumer Guidance & Cost Commentary
For this blood test service at Rooks County Health Center in Plainville, Kansas, the cash price of $25.00 is lower than the facility's negotiated rates, which range from $30.00 to $34.00 depending on the insurance carrier. While the cash price is also slightly higher than the Medicare benchmark of $8.46, it remains significantly below the gross chargemaster rate of $34.00. Patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rates paid by insurers often exceed the cash amount. It is important to note that while this facility is a Critical Access Hospital owned by a Government Hospital District, commercial insurance contracts can still result in higher out-of-pocket costs compared to self-pay options.
To ensure you are not overcharged, always request a detailed itemized bill before finalizing payment, as summary bills can hide errors or unbundled charges. If you receive a balance bill from an out-of-network provider, such as for ancillary lab services, you may be entitled to protections under the No Surprises Act, which bans balance billing for emergency and non-emergency care at in-network facilities. Additionally, many hospitals offer prompt-pay discounts for upfront payments, which can further reduce the final amount owed. Since over 80% of hospital bills contain errors, do not accept a summary invoice as final; instead, demand a line-by-line audit to identify any services not rendered or codes that should have been bundled.