Blood test, basic metabolic panel
Facility: Community Memorial Healthcare, Inc.
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $18
- Cash Discount Price: $29
- vs. Medicare Baseline: 2.13x 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 213% of the Medicare baseline (a markup of 113%). 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 | $13 - $22 | 154% |
| UnitedHealthcare | $17 | 201% |
| Blue Cross Blue Shield | $20 | 236% |
Consumer Guidance & Cost Commentary
For this basic metabolic panel blood test at Community Memorial Healthcare in Marysville, KS, the cash price is $29.00, which matches the facility's median paid amount. While the facility's negotiated rates with major payers like Aetna and UnitedHealthcare range from $13 to $22, the cash price remains the same as the Medicare benchmark of $8.46 adjusted for local costs. Patients with high-deductible plans may find paying the full cash price of $29.00 more cost-effective than using insurance, as the negotiated rates often exceed the cash rate due to administrative overhead and contract structures. It is important to verify if your specific plan has a deductible that would otherwise require you to pay the higher negotiated amount before scheduling.
To ensure you are not overcharged, always request a detailed, itemized bill before paying, as summary bills can obscure individual code costs and potential errors. If you receive a balance bill for the difference between the provider's full charge and your insurance allowed amount, you may have protections under the No Surprises Act, particularly if the facility is in-network or if the service was emergency care. Additionally, ask the billing department about prompt-pay discounts, which can reduce the final amount owed by 20% to 50% if settled upfront, bypassing the costly claims processing cycle that inflates commercial rates. Comparing this specific charge to state and county averages helps identify if the facility's pricing aligns with regional standards for this essential diagnostic service.