Blood test, basic metabolic panel
Facility: Golden Valley Memorial Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $8
- Cash Discount Price: $112
- vs. Medicare Baseline: 0.95x 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.
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 |
|---|---|---|
| Aetna | $8 | 95% |
| Home State Health | $8 | 95% |
| Humana | $8 | 95% |
| UnitedHealthcare | $8 - $14 | 95% |
| Ambetter / Centene | $10 | 118% |
Consumer Guidance & Cost Commentary
If you are paying cash for this blood test, you should know that the facility's self-pay rate is $112, which is significantly lower than the typical commercial insurance negotiated rate of $8. While commercial plans often cover more of the cost, the cash price is notably higher than the state and county averages for this service. For patients with high-deductible plans, paying the cash rate of $112 upfront might be the most cost-effective option if their insurance has not yet met their deductible, especially since the negotiated rate of $8 is often subject to your out-of-pocket maximums and administrative fees. However, it is crucial to verify if the facility offers a "prompt-pay" discount, as hospitals frequently provide a fee reduction for immediate payment that could lower the final amount owed.
The broader pricing context reveals that the gross chargemaster rate for this procedure is $186, which serves as the facility's maximum list price. This amount is substantially higher than the Medicare benchmark rate of $8.46, illustrating the markup difference between commercial billing and federal reimbursement standards. Although the median negotiated rate across payers is $8, individual rates vary by plan; for instance, UnitedHealthcare plans may see a range between $8 and $14 depending on the specific plan details, while Aetna, Home State Health, and Humana consistently pay $8. Patients should be aware that even at an in-network facility, unexpected balance billing can occur if ancillary services like this lab test are billed out-of-network, though the No Surprises Act provides protections for emergency care. To ensure accuracy, always request a full itemized bill before paying, as summary invoices can sometimes obscure errors or unbundled