Blood test, basic metabolic panel
Facility: Children'S Mercy South
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $64
- Cash Discount Price: $48
- vs. Medicare Baseline: 7.57x 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 757% of the Medicare baseline (a markup of 657%). 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 |
|---|---|---|
| UnitedHealthcare | $8 - $67 | 95% |
| Healthy Blue | $9 - $23 | 106% |
| Medicaid / KanCare | $10 | 118% |
| Home State Health | $20 | 236% |
| Blue Cross Blue Shield | $41 - $73 | 485% |
| Cigna | $48 - $69 | 567% |
| Medica | $58 | 686% |
| Aetna | $59 - $67 | 697% |
| Centivo | $64 | 757% |
| Quiktrip | $64 | 757% |
| Wellfit/Centrus | $64 | 757% |
| Health Midwest Comprehensive Care | $64 | 757% |
| Orscheln | $64 | 757% |
| Nebraska Furniture Mart | $64 | 757% |
| Wppa Providrs Care | $64 | 757% |
| Humana | $66 | 780% |
| Coventry Health Care Of Kansas | $73 | 863% |
| Coxhealth Network | $73 | 863% |
| Mercy Health | $74 | 875% |
| Multiplan | $75 | 887% |
| American Healthcare Alliance | $84 | 993% |
| Healthlink | $87 | 1028% |
| National Preferred Provider Network | $89 | 1052% |
Consumer Guidance & Cost Commentary
For the basic metabolic panel at Children's Mercy South in Overland Park, the cash price of $48.00 is significantly lower than the facility's negotiated rates, which range from $8 to $89 across 23 different insurance plans. While the facility's negotiated average of $64.00 is higher than the cash price, patients with high-deductible plans may find the cash rate more advantageous if their insurance negotiated rate exceeds $48.00. It is important to note that commercial insurance rates often include administrative costs for claims processing, which can inflate the final bill compared to a direct cash payment. Additionally, the facility's cash rate is notably lower than the Medicare benchmark of $8.46 for this procedure, suggesting that the cash price aligns closely with the true cost of service delivery rather than the inflated chargemaster lists often used for comparison.
Patients should be aware that prompt-pay discounts, typically ranging from 20% to 50%, may further reduce the $48.00 cash price if paid in full upfront within 30 days of the service. To secure this discount, it is essential to request self-pay classification and a prompt-pay rate waiver before check-in, as billing systems may automatically submit claims to insurance carriers if a card is on file. Furthermore, under the No Surprises Act, patients are protected from balance billing for out-of-network services at in-network facilities, though they should still review itemized bills to ensure no unbundled codes or services not rendered are included. Given that over 80% of hospital bills contain errors, requesting a detailed, line-by-line audit before finalizing payment is a critical step to avoid unexpected charges.