Blood test, basic metabolic panel
Facility: Graham County Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $20
- Cash Discount Price: $28
- vs. Medicare Baseline: 2.36x 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 236% of the Medicare baseline (a markup of 136%). 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 - $27 | 24% |
| Medicaid / KanCare | $14 | 165% |
| Blue Cross Blue Shield | $19 | 225% |
| Medicare (plans) | $21 | 248% |
| Celtic Commercial-All Other Plans | $23 | 272% |
| Wppa (Providers Care)-All Plans | $27 | 319% |
Consumer Guidance & Cost Commentary
For this blood test service at Graham County Hospital in Hill City, Kansas, the cash price is $28.00, which matches the facility's median negotiated rate. While the hospital's cash price is slightly higher than the state average of $22.00, it remains significantly lower than the gross chargemaster price of $28.00 listed in the data, indicating no markup beyond the base rate for this specific code. Patients with high-deductible plans may find paying the cash price directly more cost-effective than using insurance, as the negotiated rates for payers like UnitedHealthcare and Blue Cross Blue Shield can sometimes exceed the cash amount due to administrative overheads included in commercial contracts.
To minimize potential costs, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can lower the final bill by 20% to 50%. If you are billed for this service out-of-network, the No Surprises Act protects you from balance billing for emergency care and non-emergency services at in-network facilities, so any unexpected charges should be disputed in writing. Additionally, since over 80% of hospital bills contain errors, you should request a full itemized statement showing specific CPT codes rather than accepting a summary bill, and verify that all charges correspond to services actually rendered before making a payment.