Blood test, basic metabolic panel
Facility: Scott County Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $71
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 8.39x 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 839% of the Medicare baseline (a markup of 739%). 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 |
|---|---|---|
| UnitedHealthcare | $8 - $75 | 95% |
| Blue Cross Blue Shield | $20 | 236% |
| Humana | $33 | 390% |
| Wppa | $47 - $1,200 | 556% |
| Aetna | $71 | 839% |
Consumer Guidance & Cost Commentary
For the blood test, basic metabolic panel (CPT 80048) at Scott County Hospital in Scott City, KS, the facility's negotiated rate of $71.00 is significantly lower than the highest allowed amount of $1200 reported by WPPA, though it remains higher than the lowest rates of $8 found by UnitedHealthcare. While the facility's negotiated rate is $71.00, the cash median is not available in this dataset, meaning patients with high-deductible plans might find paying out-of-pocket cheaper if the hospital offers a self-pay or prompt-pay discount. It is important to note that commercial negotiated rates often include administrative overhead and can exceed cash prices; therefore, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are not paying more than necessary.
When evaluating the cost, it is helpful to compare rates against the Medicare benchmark rather than the hospital's full chargemaster list. The Medicare amount for this service is $8.46, and the facility's negotiated rate is 8.4 times the Medicare amount, which aligns with the typical range of 200% to 300% of Medicare seen in commercial contracts. Since the facility is a Critical Access Hospital in a Voluntary non-profit setting, patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act. If a patient receives a bill for the difference between the allowed amount and the negotiated rate, they should request an itemized audit to verify that no unbundled codes or services not rendered are included, as over 8