Blood test, basic metabolic panel
Facility: Logan County Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $69
- Cash Discount Price: $20
- vs. Medicare Baseline: 8.16x 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 816% of the Medicare baseline (a markup of 716%). 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% |
| Humana | $42 | 496% |
| Health Partners - All Plans | $95 | 1123% |
| Medicaid / KanCare | $100 | 1182% |
Consumer Guidance & Cost Commentary
For this blood test at Logan County Hospital in Oakley, Kansas, the negotiated rates paid by major insurers range from $20 to $100, while the cash price is significantly lower at $20. This cash rate is notably lower than the facility's negotiated rates and represents a substantial discount compared to the Medicare benchmark of $8.46, which serves as the objective baseline for fair pricing. Patients with high-deductible plans or those without insurance may find the $20 cash price most advantageous, as paying upfront can bypass the administrative costs and multi-layered structures that often inflate commercial negotiated rates. It is important to note that while the facility is a Critical Access Hospital owned by the local government, patients should always verify "self-pay" or "prompt-pay" discounts directly with the hospital before scheduling, as these upfront incentives can further reduce the final cost.
The data indicates that the facility's negotiated rates align closely with the median paid amount of $69.00 across the four payers listed, including Blue Cross Blue Shield, Humana, and Medicaid/KanCare. However, because the cash price of $20 is well below these negotiated amounts, patients should be aware that utilizing insurance for this service may result in higher out-of-pocket costs if their deductible has not been met or if the insurance allowed amount exceeds the cash rate. To ensure transparency and avoid unexpected charges, consumers should request a full itemized bill before paying, as summary bills often obscure individual code costs. Additionally, if any balance billing occurs due to out-of-network ancillary services, patients have the right to dispute the bill under federal protections like the No Surprises Act, rather than accepting the difference between the chargemaster and the