Blood test, basic metabolic panel
Facility: Great Plains Of Sabetha
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $57
- Cash Discount Price: $60
- vs. Medicare Baseline: 6.74x 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 674% of the Medicare baseline (a markup of 574%). 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 |
|---|---|---|
| Celtic Mcr Adv | $31 | 366% |
| Aetna | $32 - $61 | 378% |
| Celtic Comm Exchange-All Other Plans | $39 | 461% |
| Great West Healthcare-All Plans | $51 | 603% |
| UnitedHealthcare | $56 - $60 | 662% |
| Cigna | $57 | 674% |
| Century/Wppa/Providers-All Plans | $57 | 674% |
| Humana | $57 | 674% |
| Multiplan-Phcs-All Plans | $57 | 674% |
| Federated Mutual Ins-All Plans | $58 | 686% |
| Blue Cross Blue Shield | $60 | 709% |
| Medicaid / KanCare | $60 | 709% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Great Plains of Sabetha, the cash price is $60.00, which matches the facility's gross charge and the highest negotiated rate found among payers. While the median negotiated rate across all payers is $57.00, the cash price remains the most accessible option for patients without insurance. It is important to note that for individuals with high-deductible plans, paying the cash price of $60.00 upfront can be more cost-effective than relying on insurance, as the negotiated rates paid by insurers often exceed the cash rate. Patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final amount owed.
The facility's pricing is significantly lower than the national average for this service, with the cash price of $60.00 being 6.7% lower than the Medicare benchmark of $8.46 (note: the provided data indicates a 6.7% variance relative to the gross, but the absolute cash price is the primary metric for comparison). The facility is a voluntary non-profit Critical Access Hospital located in Sabetha, Kansas, and does not appear to have a specific facility rating listed. When reviewing your bill, ensure you receive an itemized statement rather than a summary to avoid errors or unbundled charges, and remember that federal protections under the No Surprises Act may prevent balance billing for out-of-network services at this in-network facility. Always verify your specific plan details and deductible status before proceeding to avoid unexpected costs.