Blood test, basic metabolic panel
Facility: Cloud County Health Center
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $114
- Cash Discount Price: $84
- vs. Medicare Baseline: 13.48x 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 1348% of the Medicare baseline (a markup of 1248%). 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 |
|---|---|---|
| Aetna | $108 - $112 | 1277% |
| Health Partners - All Plans | $114 | 1348% |
| Mpi-All Plans | $114 | 1348% |
| Pponext-All Plans | $114 | 1348% |
Consumer Guidance & Cost Commentary
For this blood test at Cloud County Health Center in Concordia, KS, the facility's cash price of $84.00 is lower than the state average for this service. While the facility's negotiated rate with major payers like Aetna and Health Partners is $114.00, patients with high-deductible plans might find the cash price more advantageous if their insurance allows a higher allowed amount than the cash rate. It is important to note that the facility is a Critical Access Hospital, and while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan details before scheduling.
To ensure you are not overcharged, always request an itemized bill before paying, as summary bills can hide errors or unbundled charges. Additionally, ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final cost if you settle the bill upfront. When evaluating the facility's pricing, compare the negotiated rate of $114.00 against the Medicare benchmark of $8.46; while commercial rates are typically higher than Medicare due to administrative costs, the cash price of $84.00 represents a significant discount compared to the standard negotiated fees.