CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Mercy Hospital Lincoln

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $107
Cash Discount Price: $146
vs. Medicare Baseline: 12.65x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Mercy Hospital Lincoln is $107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $146. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 12.65x the Medicare baseline. Located in 1000 East Cherry Street, Troy, MO.

Cash / Self-Pay

$146

Average discount available for prompt cash payment at this facility.

Insurance Median

$107

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$8.46

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.46 (100%)

Cash / Self-Pay: $146 (1726%)

Insurance Median: $107 (1265%)

Cash: $146 (1726% of Medicare)

Ins. Median: $107 (1265% of 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 1265% of the Medicare baseline (a markup of 1165%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
United Medical Resources Contracted [320454]	$8	95%
UnitedHealthcare	$8 - $53	95%
Blue Cross Blue Shield	$10 - $107	118%
Cigna	$11 - $56	130%
Medicaid / KanCare	$11 - $103	130%
Healthlink Contracted [320179]	$12 - $191	142%
Aetna	$34 - $147	402%
Tricare	$48	567%
Medicare (plans)	$49 - $225	579%
American Health Advantage Of Mo Mcr [10473]	$53	626%
Cherokee Nation Health Serv Contracted [320066]	$53	626%
Cross Timbers Hospice [20098]	$53	626%
Dept Of Veteran Affairs Contracted [320106]	$53	626%
Elara Caring Aspire Hospice Contracted [320433]	$53	626%
Elara Caring Aspire Hospice [20433]	$53	626%
Globalhealth Contracted [320145]	$53	626%
Halo Hcr Inc Hospice Contracted [320432]	$53	626%
Halo Hcr Inc Hospice [20432]	$53	626%
Humana	$53 - $202	626%
Indian Health Service Contracted [320198]	$53	626%
Kindful Hospice Contracted [320434]	$53	626%
Kindful Hospice [20434]	$53	626%
Mercy Hospice Okc [20252]	$53	626%
Pace Of The Ozarks Contracted [320518]	$53	626%
Provider Partners Health Plans Contracted [320450]	$53	626%
Qual Choice Contracted [320325]	$53	626%
Centivo Contracted [320505]	$82	969%
Medica Contracted [320239]	$94	1111%
Ambetter / Centene	$103	1217%
Home State Health Plan Contracted [320187]	$103	1217%
Novasys Contracted [320285]	$103	1217%
Hope Trust Contracted [320488]	$111	1312%
Health Choices Contracted [320448]	$135	1596%
Health Choices [20448]	$135	1596%
Medical Associates Health Contracted [320444]	$135	1596%
First Health Contracted [320128]	$147 - $169	1738%
Mercy Mgd Behavioral Health Contracted [320259]	$169	1998%
Multiplan Contracted [320270]	$169	1998%
Private Health Care Systems Contracted [320320]	$169	1998%
Workers Comp [20426]	$169 - $180	1998%
Aither Health Contracted [320449]	$191	2258%
Aither Health [20449]	$191	2258%
Auxiant Contracted [320462]	$191	2258%
Ebms Contracted [320493]	$191	2258%
Edison Health Solutions Contracted [320502]	$191	2258%
Federal Medical Center Contracted [320127]	$191	2258%
Imagine 360 Contracted [320494]	$191	2258%
Insurance System Inc Contracted [320465]	$191	2258%
Mercy Benefit Admin Contracted [320251]	$191	2258%
Mercy Benefit Admin [20251]	$191	2258%
Point C Contracted [320238]	$191	2258%
Preferred Health Plan Contracted [320522]	$191	2258%
Reflect Health Contracted [320492]	$191	2258%
Show-Me Health Administrators Contracted [320483]	$191	2258%
Tri State Healthcare Coalition Contracted [320379]	$191	2258%
Yuzu Health Contracted [320521]	$191	2258%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $146.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80048.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercy Hospital Lincoln is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 80048.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.