Blood test, basic metabolic panel
Facility: Kiowa County Memorial Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $86
- Cash Discount Price: $82
- vs. Medicare Baseline: 10.17x 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 1017% of the Medicare baseline (a markup of 917%). 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 - $86 | 236% |
| UnitedHealthcare | $78 - $97 | 922% |
| Health Partners Of Ks-All Plans | $85 | 1005% |
| Aetna | $86 | 1017% |
| Celtic Comml Exchange-All Other Plans | $86 | 1017% |
| Medica Prime Mcare Cost-All Plans | $86 | 1017% |
| Humana | $86 | 1017% |
| Medicaid / KanCare | $97 | 1147% |
| Providrs Care/Wppa-All Plans | $146 | 1726% |
Consumer Guidance & Cost Commentary
For the basic metabolic panel blood test (CPT 80048), Kiowa County Memorial Hospital in Greensburg, KS, has a cash median price of $82.00 and a median negotiated rate of $86.00. While the facility is a Critical Access Hospital owned by the local government, the negotiated rate is slightly higher than the cash price, which can be advantageous for patients with high-deductible plans who may not yet have met their out-of-pocket threshold. It is important to note that commercial payers like Blue Cross Blue Shield and UnitedHealthcare have negotiated rates ranging from $20 to $97, with most plans clustering between $85 and $97. Patients should verify their specific plan's deductible status before relying on insurance, as paying the full negotiated rate without meeting a deductible can result in higher out-of-pocket costs than paying cash directly.
When evaluating this charge, it is crucial to compare rates against the Medicare benchmark rather than the hospital's gross charge, as the latter is often inflated. The Medicare amount for this service is $8.46, which serves as the objective baseline for fair pricing; commercial negotiated rates typically range from 200% to 300% of this amount, though fair pricing is generally defined as 120% to 150%. Additionally, patients should inquire about prompt-pay discounts, which can reduce bills by 20% to 50% if paid in full upfront, bypassing the administrative costs associated with insurance claims processing. Finally, if you have insurance, ensure you request a waiver of insurance submission to avoid automatic claims that might void any cash discounts, and always ask for an itemized