Blood test, basic metabolic panel
Facility: Lincoln County Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $20
- Cash Discount Price: $106
- vs. Medicare Baseline: 2.36x 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 236% of the Medicare baseline (a markup of 136%). 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 | 236% |
Consumer Guidance & Cost Commentary
For this basic metabolic panel at Lincoln County Hospital in Lincoln, KS, the cash price of $106.00 is significantly lower than the facility's negotiated rate of $20.00, which represents the maximum amount commercial insurers like Blue Cross Blue Shield are contractually allowed to pay. While the facility is a Critical Access Hospital with government ownership, patients should be aware that insurance negotiated rates often include administrative overhead and do not reflect the actual cost of care. In cases where a patient has a high deductible or self-pay preference, paying the cash price directly can be more cost-effective than relying on insurance, as the insurer's allowed amount may exceed the cash rate. It is important to verify the specific allowed amount with your plan before scheduling, as in-network rates vary even within the same facility.
To ensure you are receiving the best possible price, we recommend requesting a "prompt-pay" discount from the hospital if you choose to pay out of pocket, as these upfront payments often reduce the bill by 20% to 50% by bypassing costly claims processing. Additionally, since Medicare sets the benchmark for this service at $8.46, the commercial cash price of $106.00 represents a markup relative to the federal government's cost basis, which is a standard practice in commercial healthcare. If you receive an itemized bill later, you should review it carefully to ensure no services were double-billed or unbundled, as over 80% of hospital bills contain errors that can be corrected through a formal written audit. Always confirm your deductible status and ask for a self-pay classification prior to check-in to avoid unexpected charges.