Blood test, basic metabolic panel
Facility: Fredonia Regional Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $52
- Cash Discount Price: $57
- vs. Medicare Baseline: 6.15x 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 615% of the Medicare baseline (a markup of 515%). 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 | $5 - $52 | 59% |
| Blue Cross Blue Shield | $20 - $28 | 236% |
| Veterans Programs - All Plans | $29 | 343% |
| Aetna | $29 - $52 | 343% |
| Cigna | $52 | 615% |
| Meritain-All Plans | $52 | 615% |
| Reserve National-All Plans | $52 | 615% |
Consumer Guidance & Cost Commentary
For the basic metabolic panel at Fredonia Regional Hospital in Fredonia, Kansas, the cash price is $57.00, which matches the facility's cash median. This rate is significantly higher than the Medicare benchmark of $8.46, reflecting the standard markup for commercial services. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find the cash price more affordable than their insurance negotiated rates, which range from $29.00 to $52.00 depending on the payer. It is important to note that while the negotiated rates are generally lower than the cash price, they still exceed the Medicare baseline, and patients should verify their specific plan's allowed amount before scheduling to avoid unexpected out-of-pocket costs.
To minimize billing surprises, patients should request a prompt-pay discount before check-in, as paying the full cash price upfront can sometimes result in a fee reduction of 20% to 50%. Additionally, if you have insurance, ensure you do not sign any waivers that allow the hospital to submit a claim to your insurer, as this could void your agreement to pay the cash rate and trigger balance billing. Since over 80% of hospital bills contain errors, always request a detailed, itemized statement rather than accepting a summary bill, and dispute any discrepancies in writing to ensure you are only charged for services actually rendered.