Blood test, basic metabolic panel
Facility: Clay County Medical Center
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $37
- Cash Discount Price: $39
- vs. Medicare Baseline: 4.37x 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 437% of the Medicare baseline (a markup of 337%). 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 | $36 | 426% |
| Wppa/Providrs Care- All Plans | $36 | 426% |
| Health Partners - All Plans | $37 | 437% |
| UnitedHealthcare | $37 | 437% |
| Multiplan- All Plans | $37 | 437% |
Consumer Guidance & Cost Commentary
For the blood test, basic metabolic panel (CPT 80048) at Clay County Medical Center in Clay Center, KS, the cash price is $39.00, which matches the facility's median negotiated rate of $37.00 and the cash median of $39.00. This price is notably higher than the state average of $8.46, reflecting the facility's status as a Critical Access Hospital with government-local ownership. While commercial payers like Aetna and UnitedHealthcare have negotiated rates of $36.00 to $37.00, patients with high-deductible plans may find paying the cash price directly more cost-effective if their insurance allowed amount exceeds $39.00. It is important to note that commercial rates often include administrative overhead, whereas cash prices represent the direct cost of the service without insurance processing fees.
Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, unexpected ancillary charges can still occur if specific lab components are billed separately. To avoid potential disputes, consumers should request a full itemized bill before paying, ensuring no unbundled codes or services not rendered are included. Additionally, since the facility offers prompt-pay discounts for upfront payment, patients should explicitly ask for self-pay rates or prompt-pay reductions prior to scheduling to ensure they receive the lowest possible price. Comparing the $39.00 cash rate to the Medicare benchmark of $8.46 reveals a significant markup, highlighting the importance of verifying the true cost of care rather than relying on inflated chargemaster lists.