Blood test, basic metabolic panel
Facility: St Luke Hospital & Living Center
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $42
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 4.96x 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 496% of the Medicare baseline (a markup of 396%). 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 |
|---|---|---|
| Kansas Department Of Health And Environment | $42 | 496% |
| Va Ccn | $42 | 496% |
| UnitedHealthcare | $42 | 496% |
| Bluestem Pace | $42 | 496% |
| Blue Cross Blue Shield | $42 | 496% |
| Humana | $42 | 496% |
| Ambetter / Centene | $43 | 508% |
Consumer Guidance & Cost Commentary
For the blood test, basic metabolic panel (CPT code 80048) at St Luke Hospital & Living Center in Marion, KS, the facility's negotiated rate is $42.00, which aligns with the lowest and highest negotiated amounts reported for this service in the state. This rate is significantly lower than the gross chargemaster price of $83.00, reflecting the contractual caps that protect in-network members from balance billing. While cash payments are not listed in this report, patients should note that commercial negotiated rates often exceed cash prices; therefore, individuals with high-deductible plans may find it financially advantageous to pay cash directly if the facility offers a self-pay or prompt-pay discount, which can range from 20% to 50% off the billed amount.
When evaluating the cost of this service, it is important to understand that the facility's rate is based on a Medicare benchmark of $8.46, with the commercial negotiated rate representing a markup relative to this federal baseline. Although the report does not provide specific county or state average data for this exact procedure, the facility is a Critical Access Hospital owned by a Government Hospital District, which often influences pricing structures to remain competitive within the region. To ensure you are receiving the best possible rate, we recommend verifying your specific plan's deductible status before scheduling, as paying out-of-pocket may be cheaper if your insurance has not yet covered the service. If you receive a bill that appears higher than the $42.00 negotiated rate, you should request a formal itemized audit to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors that can be corrected.