Blood test, basic metabolic panel
Facility: Wilson Medical Center
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $19
- Cash Discount Price: $27
- vs. Medicare Baseline: 2.25x 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 225% of the Medicare baseline (a markup of 125%). 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 | $5 - $57 | 59% |
| Ambetter / Centene | $5 - $61 | 59% |
| Humana | $5 - $32 | 59% |
| Tricare | $5 - $32 | 59% |
| Aetna | $5 - $61 | 59% |
| Cigna | $8 - $49 | 95% |
| Mulitplan-All Plans | $9 - $56 | 106% |
| Health Partners-All Plans | $9 - $56 | 106% |
| Blue Cross Blue Shield | $10 - $61 | 118% |
Consumer Guidance & Cost Commentary
For this blood test at Wilson Medical Center in Neodesha, KS, the cash price is $27.00, which is lower than the facility's negotiated rates of $19.00 to $61.00 across nine insurance plans. While commercial insurance contracts often result in higher allowed amounts due to administrative costs and network tiering, paying cash upfront can be more cost-effective for patients with high deductibles or those without insurance. The facility, a Critical Access Hospital owned by the local government, lists a cash median of $27.00, which is notably lower than the national average for this procedure. Patients should verify their specific plan's deductible status before scheduling, as paying the negotiated rate may not be necessary if they have not yet met their out-of-pocket threshold.
To avoid unexpected costs, consumers should request a prompt-pay discount or self-pay rate directly from the hospital before check-in, as these discounts can reduce the final bill by 20% to 50%. If you receive a bill after using insurance, ensure it is an itemized statement rather than a summary bill, as hospitals may bundle charges or include services not rendered. Under federal protections like the No Surprises Act, you are generally shielded from balance billing for emergency care or non-emergency services at in-network facilities, but it is crucial to dispute any out-of-network charges in writing rather than accepting them immediately. Always compare the final allowed amount to the Medicare benchmark of $8.46 for this code to understand the true cost basis, as commercial rates often exceed fair pricing standards.