Blood test, basic metabolic panel
Facility: Clara Barton Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $113
- Cash Discount Price: $88
- vs. Medicare Baseline: 13.36x 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 1336% of the Medicare baseline (a markup of 1236%). 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 | $19 | 225% |
| 6 Degrees Health - All Plans | $88 | 1040% |
| Wppa-All Plans | $101 | 1194% |
| Aetna | $113 | 1336% |
| Phcs - All Plans | $113 | 1336% |
| UnitedHealthcare | $113 | 1336% |
| Hlth Partners Of Ks-All Plans | $116 | 1371% |
Consumer Guidance & Cost Commentary
For this blood test at Clara Barton Hospital in Hoisington, KS, the facility's negotiated rates range from $19 to $116, with a median negotiated amount of $113.00. This figure is notably higher than the cash median of $88.00, which may be a more favorable option for patients with high-deductible plans who have not yet met their out-of-pocket maximum. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the negotiated rates reflect standard commercial pricing dynamics where administrative costs and contract management inflate the baseline price. It is important to note that the facility's rating is 2, which may influence patient choice, though the primary focus here remains on the financial transparency of the service.
When evaluating the cost against federal benchmarks, the Medicare amount for this procedure is $8.46, which serves as the objective baseline for pricing evaluation. The facility's cash rate of $88.00 represents a significant markup over the Medicare benchmark, illustrating the typical commercial pricing structure where rates can exceed the federal cost basis by several hundred percent. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, it does not eliminate the difference between the negotiated rate and the cash price. To potentially reduce costs, patients are encouraged to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can offer immediate fee reductions for upfront payment and bypass the administrative overhead associated with insurance claims.