Blood test, basic metabolic panel
Facility: Greenwood County Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $161
- Cash Discount Price: $153
- vs. Medicare Baseline: 19.03x 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 1903% of the Medicare baseline (a markup of 1803%). 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 |
|---|---|---|
| UnitedHealthcare | $16 - $160 | 189% |
| Blue Cross Blue Shield | $18 - $19 | 213% |
| Triwest - All Plans | $68 | 804% |
| Tricare | $80 | 946% |
| Choicecare Mcr Adv - All Plans | $80 | 946% |
| Integrated Health Plan - All Plans | $143 | 1690% |
| First Health Ccn Network | $162 | 1915% |
| Beech Street - All Plans | $162 | 1915% |
| First Health - All Other Plans | $162 | 1915% |
| Preferred Hs (Coventry) - All Plans | $172 | 2033% |
| Principal Health Care Inc - All Plans | $181 | 2139% |
| Amerigroup Mcaid-All Plans | $191 | 2258% |
| Medicaid / KanCare | $191 | 2258% |
| Providrs Care/Wppa - All Plans | $286 | 3381% |
Consumer Guidance & Cost Commentary
For this blood test, basic metabolic panel, Greenwood County Hospital in Eureka, KS, offers a cash price of $153.00, which is lower than the facility's negotiated rates of $161.00. While the facility is a Critical Access Hospital with government local ownership, patients should be aware that commercial insurance plans often pay negotiated rates exceeding the cash price due to administrative costs and contract structures. If you have a high-deductible plan, paying the cash price upfront may result in immediate savings compared to your insurance allowing a higher negotiated amount, provided you have not yet met your deductible. Additionally, many facilities offer prompt-pay discounts for self-pay patients who settle their bill in full within a short window, so it is advisable to ask the billing department about these incentives before scheduling your appointment.
The Medicare benchmark for this service is $8.46, which serves as a baseline for evaluating the facility's pricing markup. The cash price of $153.00 is significantly higher than the Medicare rate, reflecting the typical range where commercial rates can be 18 to 20 times the Medicare amount. However, the negotiated rates paid by insurance carriers, such as UnitedHealthcare and Blue Cross Blue Shield, generally align closely with the cash price, suggesting that the facility's billing structure for this specific code does not involve significant balance billing risks for in-network members. To ensure you are receiving the most accurate pricing, always request an itemized bill that lists specific CPT codes rather than accepting a summary invoice, as this helps identify any unbundled charges or services not rendered.