Blood test, basic metabolic panel
Facility: Hospital District #6 Patterson Health Center
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $63
- Cash Discount Price: $56
- vs. Medicare Baseline: 7.45x 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 745% of the Medicare baseline (a markup of 645%). 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 | $18 - $19 | 213% |
| UnitedHealthcare | $63 - $70 | 745% |
| Providers Care (Wppa)-All Plans | $122 | 1442% |
Consumer Guidance & Cost Commentary
For the basic metabolic panel blood test (CPT 80048) at the Hospital District #6 Patterson Health Center in Anthony, KS, the facility's cash median price of $56.00 is notably lower than the state average for this service. While the facility's negotiated rates with major payers like Blue Cross Blue Shield and UnitedHealthcare range from $18 to $70, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. It is important to note that commercial insurance rates frequently include administrative overhead and do not reflect the true cost of care; comparing these negotiated amounts to the Medicare benchmark of $8.46 reveals a significant markup, suggesting that the "fair" price for this service typically falls between 120% and 150% of the Medicare rate.
Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network emergency services at in-network facilities, unexpected charges can still occur if ancillary services are billed separately. To avoid surprise costs, consumers should request an itemized bill before paying and verify that all charges are accurate, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, since the facility offers a cash median price of $56.00, patients should explicitly ask about "self-pay" or "prompt-pay" discounts at the time of registration, as paying upfront can often reduce the total amount owed by bypassing costly insurance claims processing and administrative fees.