Blood test, basic metabolic panel
Facility: Medicine Lodge Memorial Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $48
- Cash Discount Price: $50
- vs. Medicare Baseline: 5.67x 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 567% of the Medicare baseline (a markup of 467%). 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 |
|---|---|---|
| Tricare | $40 | 473% |
| Humana | $46 | 544% |
| Aetna | $47 - $50 | 556% |
| Hpk-All Plans | $48 | 567% |
| UnitedHealthcare | $48 | 567% |
| Medicaid / KanCare | $50 | 591% |
Consumer Guidance & Cost Commentary
For the basic metabolic panel blood test (CPT 80048) at Medicine Lodge Memorial Hospital in Medicine Lodge, KS, the facility's cash price is $50.00, which matches the median negotiated rate of $48.00 and the gross charge of $50.00. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients should be aware that insurance negotiated rates can sometimes exceed cash prices; in this case, the cash rate is identical to the negotiated amount, meaning paying out-of-pocket may not result in savings compared to using insurance. However, if a patient has a high-deductible plan where the deductible has not yet been met, the $50.00 cash price could be more predictable than an insurance claim that might result in a higher allowed amount before the deductible is satisfied.
To ensure you are receiving the most accurate pricing, it is important to request an itemized billing audit if you receive a summary bill, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, if you are concerned about balance billing, remember that the No Surprises Act generally protects patients from being billed the difference between the facility's chargemaster and their insurance allowed amount for emergency care or non-emergency services at in-network facilities. Since this facility is in-network for the listed payers, including Tricare, Humana, and Aetna, you should verify your specific plan details and ask the hospital directly about any available self-pay or prompt-pay discounts before scheduling your visit to avoid unexpected costs.