Blood test, basic metabolic panel
Facility: William Newton Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $19
- Cash Discount Price: $37
- vs. Medicare Baseline: 2.25x 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 225% of the Medicare baseline (a markup of 125%). 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 |
|---|---|---|
| Ambetter / Centene | $2 - $53 | 24% |
| UnitedHealthcare | $4 - $48 | 47% |
| Triwest- All Plans | $8 - $19 | 95% |
| Blue Cross Blue Shield | $8 - $19 | 95% |
| Providrs Care Nexus | $32 | 378% |
| Providrs Care - All Other Plans | $37 | 437% |
Consumer Guidance & Cost Commentary
For the CPT code 80048, representing a basic metabolic panel at William Newton Hospital in Winfield, KS, the cash median price is $37.00, which matches the facility's gross charge. This cash rate is significantly higher than the Medicare benchmark of $8.46, reflecting a markup common in commercial pricing 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 be aware that commercial negotiated rates for this service range from $19.00 to $37.00 depending on the insurance carrier, with UnitedHealthcare and Ambetter / Centene negotiating rates between $4 and $19.00. Because the cash price of $37.00 is lower than the highest negotiated rates found in this dataset, patients with high-deductible plans or those who have not yet met their out-of-pocket maximum may find paying cash directly more cost-effective than using insurance, provided the facility offers a prompt-pay discount.
Before finalizing payment, it is crucial to verify the specific allowed amount for your plan, as commercial rates vary widely by payer and can sometimes exceed the cash price due to administrative overhead and contract dynamics. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still request an itemized billing audit to ensure no unbundled codes or services not rendered are included in the final statement. Given that over 80% of hospital bills contain errors, obtaining a detailed line-by-line breakdown is essential for identifying discrepancies. Additionally, since the facility is located in Winfield (