Blood test, basic metabolic panel
Facility: Sheridan County Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $27
- Cash Discount Price: $39
- vs. Medicare Baseline: 3.19x 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 319% of the Medicare baseline (a markup of 219%). 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 Insurance | $24 | 284% |
| Blue Cross Blue Shield | $27 | 319% |
| UnitedHealthcare | $37 | 437% |
Consumer Guidance & Cost Commentary
For this blood test at Sheridan County Hospital in Hoxie, Kansas, the cash price is $39.00, which matches the facility's median negotiated rate of $27.00 and the cash median. This cash price is significantly higher than the Medicare benchmark of $8.46, reflecting the standard markup for commercial services. While the facility is a Critical Access Hospital with government local ownership, the specific pricing for this service does not appear in the provided data to allow for a direct comparison with state or county averages. Patients should note that while insurance typically negotiates a lower ceiling rate than the cash price, the actual amount you pay depends on your deductible status and whether your plan covers this specific code.
To minimize out-of-pocket costs, we recommend verifying your deductible balance before scheduling, as paying the full negotiated rate may be necessary if you haven't met your plan's threshold. If you have a high-deductible plan, paying the cash price of $39.00 upfront might be more economical than your insurance's negotiated rate, which could exceed the cash price depending on your specific carrier. Additionally, ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if settled in full within 30 days. Always request a detailed, itemized bill before paying to ensure no errors or unbundled charges are included, as over 80% of hospital bills contain discrepancies that can be corrected through a formal audit.