Blood test, basic metabolic panel
Facility: Morris County Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $60
- Cash Discount Price: $92
- vs. Medicare Baseline: 7.09x 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 709% of the Medicare baseline (a markup of 609%). 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 |
|---|---|---|
| Providrs Care (Wppa)(Nexus)-All Plans | $8 | 95% |
| Aetna | $10 | 118% |
| Va Ccn-All Plans | $13 | 154% |
| Blue Cross Blue Shield | $19 - $60 | 225% |
| Choice Care Mcr Adv-All Plans | $60 | 709% |
| UnitedHealthcare | $60 - $154 | 709% |
| Coventry Mcr | $60 | 709% |
| Cigna | $111 | 1312% |
| Multiplan-All Plans | $139 | 1643% |
| Coventry Comm-All Other Plans | $139 | 1643% |
Consumer Guidance & Cost Commentary
For the blood test, basic metabolic panel (CPT 80048) at Morris County Hospital in Council Grove, Kansas, the cash median price is $92.00, while the median negotiated rate for in-network payers is $60.00. This service is provided by a Critical Access Hospital with government-local ownership, and the facility's rating is 3. While the cash price of $92.00 is higher than the negotiated rate, patients with high-deductible plans may find paying cash directly cheaper if their insurance allows a negotiated rate that exceeds the cash price. It is important to note that the facility's location in Council Grove, KS, does not provide specific county or state average data for comparison in this report, so patients should verify local pricing trends independently.
The Medicare benchmark for this procedure is $8.46, which serves as the objective baseline for evaluating pricing markups. Commercial negotiated rates often exceed Medicare benchmarks due to administrative costs and contract dynamics, though fair pricing is typically defined as 120% to 150% of the Medicare amount. For this specific code, the gross charge is $154.00, and the median paid amount across payers is $60.00. Patients should be aware that hospitals may offer prompt-pay discounts for upfront payments, which can reduce the total cost, and they should request a self-pay classification before check-in to avoid automatic claims submission that might void such discounts. Additionally, if a patient receives an itemized bill, they should review it for errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes that can be corrected through