Blood test, basic metabolic panel
Facility: Hodgeman County Health Center
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $94
- Cash Discount Price: $107
- vs. Medicare Baseline: 11.11x 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 1111% of the Medicare baseline (a markup of 1011%). 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 | $19 - $20 | 225% |
| UnitedHealthcare | $86 - $127 | 1017% |
| Triwest - All Plans | $86 | 1017% |
| Humana | $86 | 1017% |
| Medicaid / KanCare | $86 - $134 | 1017% |
| Aetna | $107 | 1265% |
| First Health - All Plans | $121 | 1430% |
| Wppa (Provdrscare) - All Plans | $127 | 1501% |
| Health Partners - All Plans | $127 | 1501% |
Consumer Guidance & Cost Commentary
For the CPT code 80048, representing a basic metabolic panel at Hodgeman County Health Center in Jetmore, Kansas, the facility's cash price is $107.00, which aligns closely with the state average of $101.00 and is slightly higher than the national average of $107.00. While the facility is a Critical Access Hospital with government local ownership, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. For instance, UnitedHealthcare and Medicaid/KanCare have negotiated rates ranging from $86 to $134, which can be higher than the cash price for patients with high-deductible plans who may not yet have met their out-of-pocket thresholds.
To minimize costs, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts before scheduling, as paying upfront can bypass costly insurance billing cycles and administrative fees. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to request an itemized bill to ensure no unbundled charges or services not rendered are included. When evaluating the facility's pricing, comparing the $107.00 cash rate to the Medicare benchmark of $8.46 reveals a significant markup, highlighting that commercial rates are often substantially higher than the federal cost baseline.