Blood test, basic metabolic panel
Facility: F W Huston Medical Center
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $97
- Cash Discount Price: $101
- vs. Medicare Baseline: 11.47x 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 1147% of the Medicare baseline (a markup of 1047%). 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% |
| Aetna | $94 | 1111% |
| Humana | $100 | 1182% |
| Cigna | $107 | 1265% |
Consumer Guidance & Cost Commentary
For the basic metabolic panel at F W Huston Medical Center in Winchester, KS, the facility's cash price of $101.00 is notably lower than the state average, which sits at $126.00. While the facility's negotiated rates with major insurers like Blue Cross Blue Shield, Aetna, Humana, and Cigna range from $94 to $107, these amounts often exceed the cash price. For patients with high-deductible plans or those without insurance, paying the cash price directly can be more cost-effective than relying on insurance, as the insurer's negotiated rate may still be higher than the self-pay amount. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as paying upfront can sometimes result in further fee reductions.
This service is benchmarked against Medicare, which reimburses $8.46 for this procedure, highlighting a significant markup in commercial pricing. The facility's cash rate of $101.00 is approximately 11.5% higher than the Medicare amount, reflecting the administrative costs and profit margins inherent in private healthcare delivery. Although the facility is a Critical Access Hospital owned by a voluntary non-profit, patients should remain vigilant regarding balance billing, particularly if ancillary services like emergency care or specific lab components are provided by out-of-network providers. Under the No Surprises Act, balance billing for emergency services at in-network facilities is prohibited, but patients should request a detailed, itemized bill to ensure no unbundled charges or services not rendered are included before finalizing payment.