Blood test, basic metabolic panel
Facility: Smith County Memorial Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $34
- Cash Discount Price: $36
- vs. Medicare Baseline: 4.02x 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 402% of the Medicare baseline (a markup of 302%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $19 | 225% |
| Medicaid / KanCare | $25 - $36 | 296% |
| Multiplan-All Plans | $32 | 378% |
| UnitedHealthcare | $34 | 402% |
| Midlands Choice-All Plans | $34 | 402% |
| Health Partners Of Ks Ppo-All Plans | $34 | 402% |
| Wppa-All Plans | $34 | 402% |
Consumer Guidance & Cost Commentary
For the basic metabolic panel blood test (CPT 80048) at Smith County Memorial Hospital in Smith Center, KS, the cash price is $36.00, which matches the facility's median negotiated rate of $34.00 and the cash median. This price point is notably higher than the Medicare benchmark of $8.46, reflecting a markup common in commercial billing where negotiated rates often average 200% to 300% of the federal baseline. While the facility is a Critical Access Hospital owned by the local government, patients should verify if their specific insurance plan has a lower allowed amount, as commercial negotiated rates can sometimes exceed the cash price for those with high-deductible plans.
To minimize out-of-pocket costs, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid upfront, bypassing administrative fees associated with insurance claims. Since the facility is in-network for seven payers including Blue Cross Blue Shield and Medicaid/KanCare, balance billing is unlikely for covered services under the No Surprises Act, but patients must ensure they do not sign away rights to dispute out-of-network ancillary charges. If the final bill exceeds the expected $34.00 to $36.00 range, request a full itemized audit to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors that can be corrected through written dispute.