Blood test, basic metabolic panel
Facility: Stanton County Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $130
- Cash Discount Price: $121
- vs. Medicare Baseline: 15.37x 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 1537% of the Medicare baseline (a markup of 1437%). 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 - $230 | 225% |
| Healthy Blue Mcr Adv - All Other Plans | $118 - $238 | 1395% |
| Healthy Blue Mcaid | $121 - $207 | 1430% |
Consumer Guidance & Cost Commentary
For this basic metabolic panel test at Stanton County Hospital in Johnson, KS, the cash price is $121.00, which matches the facility's gross charge and serves as the baseline for self-pay patients. While the facility is a Critical Access Hospital owned by the local government, the negotiated rates for in-network payers like Blue Cross Blue Shield range from $19 to $230, and Healthy Blue plans range from $118 to $238. This data highlights a common billing dynamic where cash payments can sometimes be more cost-effective than using insurance, particularly for patients with high deductibles, as the insurance negotiated rates often exceed the cash price. To secure the lowest possible cost, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass the administrative overhead and higher negotiated rates associated with insurance billing.
When evaluating the value of this service, it is important to compare the facility's pricing against federal benchmarks rather than the hospital's inflated list price. The Medicare amount for this procedure is $8.46, which serves as the objective baseline for true cost; commercial rates are often significantly higher due to administrative structures and contract dynamics. Although the data does not provide specific state or county average figures for comparison, the facility's cash rate of $121.00 is substantially higher than the Medicare benchmark, illustrating the typical markup found in commercial healthcare pricing. Consumers should be aware that while the No Surprises Act protects against balance billing for out-of-network emergency services at in-network facilities, it is still prudent to request an itemized bill to ensure no unbundled codes or services not rendered are included, as over 8