Blood test, basic metabolic panel
Facility: Bob Wilson Memorial Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $90
- Cash Discount Price: $44
- vs. Medicare Baseline: 10.64x 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 1064% of the Medicare baseline (a markup of 964%). 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 |
|---|---|---|
| Centura Employee Plan | $11 | 130% |
| Blue Cross Blue Shield | $26 | 307% |
| UnitedHealthcare | $35 - $92 | 414% |
| Humana | $35 | 414% |
| Kansas Health | $35 | 414% |
| Medicare (plans) | $35 | 414% |
| Aetna | $35 - $88 | 414% |
| Multiplan | $99 - $102 | 1170% |
| Health Partners Of Kansas | $103 | 1217% |
| Wppa | $105 | 1241% |
Consumer Guidance & Cost Commentary
For the CPT code 80048, representing a basic metabolic panel at Bob Wilson Memorial Hospital in Ulysses, KS, the facility's negotiated rates range from $11 to $105 across ten different payers, with a median negotiated amount of $90. This commercial rate is significantly higher than the Medicare benchmark of $8.46, reflecting the typical administrative markup inherent in insurance contracts. While the facility is a Critical Access Hospital owned by a voluntary non-profit church, patients should note that the cash median price is $44.00, which is substantially lower than the negotiated rates. For individuals with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price directly may result in lower immediate costs compared to the insurance allowed amount, provided the patient can afford the upfront payment.
To minimize potential costs, patients are encouraged to verify their specific plan's negotiated rate before scheduling, as in-network rates vary widely among carriers. It is important to check with the hospital directly regarding "self-pay" or "prompt-pay" discounts, which can offer fee reductions of 20% to 50% for upfront payments by bypassing the administrative overhead of insurance claims processing. Additionally, if a patient receives an itemized bill, they should request a full line-by-line audit to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain discrepancies. By comparing the facility's rates against the Medicare benchmark and actively seeking cash discounts or prompt-pay options, consumers can ensure they are not overpaying for essential laboratory services.