CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Kiowa District Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $83
  • Cash Discount Price: $70
  • vs. Medicare Baseline: 9.81x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Kiowa District Hospital is $83. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $70. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 9.81x the Medicare baseline. Located in 1002 South 4Th Street, Kiowa, KS.
Cash / Self-Pay
$70

Average discount available for prompt cash payment at this facility.

Insurance Median
$83

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$8.46

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.46 (100%)
Cash / Self-Pay: $70 (827%)
Insurance Median: $83 (981%)
Cash: $70 (827% of Medicare)
Ins. Median: $83 (981% of 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 981% of the Medicare baseline (a markup of 881%). 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Healthchoice-All Plans $13 154%
Blue Cross Blue Shield $19 225%
Tricare $34 402%
UnitedHealthcare $70 - $88 827%
Health Partners Of Ks-All Plans $77 910%
Humana $79 934%
Gbs Insurance - All Plans $83 981%
Multiplan-All Plans $83 981%
Medicare (plans) $84 993%
Triwest-All Plans $84 993%
Aetna $84 993%
Medicaid / KanCare $88 1040%
Providers Care (Wppa)-All Plans $132 1560%
Liberty Healthshare-All Plans $142 1678%

Consumer Guidance & Cost Commentary

For the basic metabolic panel blood test (CPT 80048) at Kiowa District Hospital in Kiowa, KS, the facility's cash median price of $70.00 is notably lower than the state average of $83.00 and the Medicare benchmark of $8.46. While the hospital is a Critical Access Hospital owned by a Government Hospital District, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. For instance, UnitedHealthcare's negotiated range spans from $70 to $88, which aligns closely with the cash rate but may still be higher than the actual cost basis. If you have a high-deductible plan, paying the $70.00 cash price upfront could save you money compared to your insurance's allowed amount, provided you have not yet met your deductible.

To maximize savings, we recommend asking the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% for upfront payments. Since the facility's cash rate is already competitive with the state average, there is little room for further negotiation on the list price, but verifying your specific plan's allowed amount is crucial to avoid balance billing. If your insurance submits a claim, ensure you review the itemized statement to confirm that no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written audit. Always request a waiver of insurance submission if you choose to pay cash to prevent the hospital from automatically billing your insurer and voiding any potential discounts.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1002 South 4Th Street, Kiowa, KS 67070
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals