Blood test, basic metabolic panel
Facility: Mitchell County Hospital Health Systems
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $180
- Cash Discount Price: $170
- vs. Medicare Baseline: 21.28x 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 2128% of the Medicare baseline (a markup of 2028%). 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 - $189 | 95% |
| Blue Cross Blue Shield | $20 | 236% |
| Triwest Well Mark All Plans | $161 | 1903% |
| Aetna | $170 | 2009% |
| First Health-All Plans | $170 | 2009% |
| Pref Hlth Care Sytms Comm - All Plans | $170 | 2009% |
| Phc Leased Ntwrk Access - All Plans | $180 | 2128% |
| Auxiant-All Plans | $180 | 2128% |
| Multiplan Ppo - All Plans | $180 | 2128% |
| Health Partners Ks-All Plans | $187 | 2210% |
| Cigna | $187 | 2210% |
Consumer Guidance & Cost Commentary
For this blood test service at Mitchell County Hospital Health Systems in Beloit, KS, the facility's cash price of $170.00 is significantly lower than the gross charge of $189.00. While the median negotiated rate across 11 payers is $180.00, patients with high-deductible plans may find the cash price more affordable if their insurance allows the full negotiated amount. It is important to note that the facility's negotiated rate of $180.00 exceeds the state average of $170.00, suggesting that commercial insurance contracts in this area may carry a higher baseline cost than the cash-pay option. Additionally, the facility's cash price is notably higher than the Medicare benchmark of $8.46, highlighting the substantial markup inherent in commercial billing structures compared to federal reimbursement rates.
To potentially reduce costs, patients should inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can range from 20% to 50% for upfront payments. Since the facility is a Critical Access Hospital owned by the local government, verifying the specific discount policy before scheduling is crucial to avoid being billed the full negotiated rate. Furthermore, because over 80% of hospital bills contain errors, patients should request a detailed, itemized statement rather than accepting a summary bill, ensuring that all charges correspond to services actually rendered. Finally, under the No Surprises Act, patients are protected from balance billing for out-of-network services at in-network facilities, so they should not feel pressured to pay unexpected differences without first disputing the claim or requesting an audit.