Blood test, basic metabolic panel
Facility: Phillips County Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $60
- Cash Discount Price: $56
- vs. Medicare Baseline: 7.09x 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 709% of the Medicare baseline (a markup of 609%). 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 | $20 - $53 | 236% |
| UnitedHealthcare | $53 - $66 | 626% |
| Health Partners-All Plans | $66 | 780% |
| Medicaid / KanCare | $66 | 780% |
Consumer Guidance & Cost Commentary
For this blood test, the facility's cash price of $56.00 is lower than the average commercial negotiated rate of $60.00, though it remains slightly higher than the state average of $51.00. While your insurance plan may cover a portion of the cost, the negotiated rate of $60.00 often exceeds the cash price, making self-pay a potentially more affordable option if you have a high deductible. To maximize savings, you should contact the hospital directly to confirm if they offer additional "self-pay" or "prompt-pay" discounts for upfront payment, which can further reduce the final amount owed.
It is important to understand that commercial insurance rates are often inflated by administrative costs and contract structures, which is why comparing them to the Medicare benchmark of $8.46 reveals a significant markup. Since Medicare rates represent a scientifically validated baseline for the true cost of care, patients should focus on comparing their out-of-network or cash rates against this figure rather than the hospital's gross list price. If you receive a bill that includes unexpected charges, you have the right to request a detailed itemized audit to identify errors or unbundled codes, as most hospital bills contain inaccuracies that can be corrected through formal dispute processes.