Blood test, basic metabolic panel
Facility: Ellsworth County Medical Center
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $66
- Cash Discount Price: $73
- vs. Medicare Baseline: 7.80x 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 780% of the Medicare baseline (a markup of 680%). 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 | $18 - $19 | 213% |
| Humana | $34 - $69 | 402% |
| Va Ccn-All Plans | $34 | 402% |
| Triwest -All Plans | $34 | 402% |
| Healthy Blue Mcr Adv | $34 | 402% |
| UnitedHealthcare | $47 - $73 | 556% |
| Aetna | $66 | 780% |
| First Health - All Plans | $66 | 780% |
| Cigna | $69 | 816% |
| Coventry Mcaid-All Plans | $73 | 863% |
| Healthy Blue Mcaid- All Other Plans | $73 | 863% |
| Medicaid / KanCare | $73 | 863% |
| Providers Care-Wppa-All Plans | $110 | 1300% |
Consumer Guidance & Cost Commentary
For this basic metabolic panel test at Ellsworth County Medical Center, the cash price is $73.00, which matches the facility's negotiated rate with UnitedHealthcare and the highest allowed amount from several other payers. While the median amount paid by insurance members is $42.00, patients with high-deductible plans may find paying the cash price of $73.00 more cost-effective if their insurance allowed amount exceeds this figure, as the out-of-pocket cost could otherwise be higher. It is important to note that the cash price is significantly lower than the facility's gross charge of $73.00, and patients should explicitly ask about self-pay or prompt-pay discounts before scheduling to ensure they receive the lowest possible rate.
When evaluating this price against broader benchmarks, the cash price of $73.00 is notably higher than the state average for this service, which is $8.46. This disparity highlights the importance of understanding that commercial negotiated rates often include administrative overhead and contract dynamics that do not reflect the true cost of care. To avoid unexpected balance billing, patients should verify their network status and ensure that any ancillary services, such as lab draws, are covered under an in-network agreement. If a surprise bill arises, consumers should request an itemized audit to identify unbundled codes or services not rendered, as over 80% of hospital bills contain errors that can be corrected through formal written disputes.