Blood test, basic metabolic panel
Facility: Trego County Lemke Memorial Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $26
- Cash Discount Price: $26
- vs. Medicare Baseline: 3.07x 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 307% of the Medicare baseline (a markup of 207%). 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 |
|---|---|---|
| Va Ccn - All Plans | $3 | 35% |
| Humana | $15 | 177% |
| Tricare | $16 | 189% |
| Medicaid / KanCare | $19 - $31 | 225% |
| Aetna | $19 - $28 | 225% |
| UnitedHealthcare | $19 - $31 | 225% |
| Ambetter / Centene | $21 | 248% |
| Blue Cross Blue Shield | $27 | 319% |
| Health Partners - All Plans | $29 | 343% |
| Healthy Blue Mcaid - All Plans | $31 | 366% |
Consumer Guidance & Cost Commentary
For the basic metabolic panel procedure (CPT 80048), Trego County Lemke Memorial Hospital has a cash median price of $26.00, which is lower than the facility's negotiated rates of $26.00 and significantly lower than the gross charge of $31.00. While the facility is a Critical Access Hospital in Wakeeney, KS, with government-local ownership, patients should be aware that commercial insurance negotiated rates vary widely among payers, ranging from $15 to $31. For individuals with high-deductible plans, paying the cash price of $26.00 upfront may be more cost-effective than relying on insurance, as the negotiated rates paid by insurers often exceed the cash price. It is important to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can further reduce the final amount owed.
The Medicare benchmark for this service is $8.46, which serves as a baseline for evaluating the facility's pricing structure. The facility's cash rate of $26.00 represents a markup relative to the Medicare amount, reflecting the costs of labor, supplies, and overhead specific to this location. When reviewing your bill, ensure you receive an itemized statement rather than a summary bill, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. If you receive a balance bill for out-of-network ancillary services, you may be entitled to protections under the No Surprises Act, which prohibits balance billing for emergency care and non-emergency services at in-network facilities. Always request a formal, written audit dispute