CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Girard Medical Center

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $50
  • Cash Discount Price: $85
  • vs. Medicare Baseline: 5.91x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Girard Medical Center is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $85. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 5.91x the Medicare baseline. Located in 302 North Hospital Drive, Girard, KS.
Cash / Self-Pay
$85

Average discount available for prompt cash payment at this facility.

Insurance Median
$50

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$8.46

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.46 (100%)
Cash / Self-Pay: $85 (1005%)
Insurance Median: $50 (591%)
Cash: $85 (1005% of Medicare)
Ins. Median: $50 (591% of 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 591% of the Medicare baseline (a markup of 491%). 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $20 - $50 236%
Aetna $50 - $248 591%
Kansas Superior Select-All Plans $50 591%
Humana $50 591%
Medicare (plans) $50 591%
UnitedHealthcare $50 - $135 591%
Ambetter / Centene $50 591%
Multiplan-All Plans $131 1548%
Uhhis-All Plans $135 1596%

Consumer Guidance & Cost Commentary

For the CPT code 80048 (Blood test, basic metabolic panel) at Girard Medical Center in Girard, KS, the facility's cash median price is $85.00, while the median negotiated rate across nine payers is $50.00. This service is provided by a Critical Access Hospital owned by a Government Hospital District. For patients with high-deductible plans, paying the cash price of $85.00 upfront may be more cost-effective than using insurance, as the negotiated rates of $50.00 to $135.00 often exceed the cash price. To maximize savings, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, which can reduce the final bill by 20% to 50% by bypassing administrative claim processing fees.

When evaluating this charge, it is important to compare rates against the Medicare benchmark rather than the hospital's gross list price. The Medicare amount for this procedure is $8.46, and the facility's negotiated rate of $50.00 represents a significant markup above this federal baseline. While the data does not provide specific state or county average figures for comparison, the facility's ownership by a Hospital District and its status as a Critical Access Hospital may influence pricing structures. Consumers should verify their specific plan's allowed amount before visiting, as in-network contracts vary widely, and ensure they receive an itemized bill to avoid errors or unbundled charges that could inflate the total cost.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 302 North Hospital Drive, Girard, KS 66743
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals