Blood test, basic metabolic panel
Facility: Norton County Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $28
- Cash Discount Price: $72
- vs. Medicare Baseline: 3.31x 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 331% of the Medicare baseline (a markup of 231%). 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 | $28 | 331% |
Consumer Guidance & Cost Commentary
For this blood test at Norton County Hospital, the cash price of $72.00 is notably lower than the facility's negotiated rate of $28.00, which represents the maximum amount Blue Cross Blue Shield pays for this service. While the facility is a Critical Access Hospital in Norton, KS, the data indicates that the negotiated rate aligns with the lowest and highest values reported for this payer, suggesting a standardized contract. However, patients should be aware that commercial negotiated rates often include administrative overhead and can exceed the cash price; in cases where your insurance deductible is high, paying the cash rate of $72.00 directly may result in significant savings compared to the insurer's allowed amount.
To maximize your out-of-pocket savings, it is essential to verify if the hospital offers a "prompt-pay" discount for upfront cash payments, which can further reduce the final bill by bypassing insurance billing cycles. Additionally, while the Medicare benchmark for this procedure is $8.46, the cash price of $72.00 reflects the facility's cost basis and local wage index rather than the federal baseline. If you receive an itemized bill later, ensure it breaks down the specific CPT code for the basic metabolic panel to avoid confusion with bundled charges or services not rendered. Always request a self-pay classification before check-in to secure the lowest possible rate and avoid unexpected balance billing.