Blood test, basic metabolic panel
Facility: Hamilton County Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $77
- Cash Discount Price: $85
- vs. Medicare Baseline: 9.10x 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 910% of the Medicare baseline (a markup of 810%). 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 | $9 - $20 | 106% |
| First Health Coventry - All Plans | $72 | 851% |
| Cigna | $81 | 957% |
| UnitedHealthcare | $81 | 957% |
| Va Ccn - All Plans | $85 | 1005% |
| Aetna | $144 | 1702% |
Consumer Guidance & Cost Commentary
For this basic metabolic panel test at Hamilton County Hospital in Syracuse, KS, the cash price is $85.00, which matches the facility's negotiated rate with several major payers including Blue Cross Blue Shield, Cigna, and UnitedHealthcare. While the median amount paid by insurers is significantly lower at $15.00, patients with high-deductible plans may find that paying the full cash price of $85.00 upfront is more cost-effective than relying on insurance, as the negotiated rates for many carriers exceed the cash rate. It is important to note that while the facility is a Critical Access Hospital with government-local ownership, the specific cash and negotiated rates for this service do not appear to be explicitly compared to broader state or county averages in the provided data, so patients should verify local pricing trends directly with the hospital or their insurance provider.
To ensure you are not overpaying, it is highly recommended to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Even if you have insurance, you should ask the billing department about "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if you pay in full within a short window, effectively bypassing the administrative overhead of the insurance claims process. Additionally, while the Medicare benchmark for this service is $8.46, commercial rates often run higher due to contract dynamics; however, since the cash price here aligns with the negotiated rates for many insurers, there is no significant markup to dispute against the Medicare baseline for this specific transaction.