CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Wheatland Memorial Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $109
Cash Discount Price: $114
vs. Medicare Baseline: 12.88x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Wheatland Memorial Hospital is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $114. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 12.88x the Medicare baseline. Located in 530 3Rd St Nw, Harlowton, MT.

Cash / Self-Pay

$114

Average discount available for prompt cash payment at this facility.

Insurance Median

$109

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: $114 (1348%)

Insurance Median: $109 (1288%)

Cash: $114 (1348% of Medicare)

Ins. Median: $109 (1288% 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 1288% of the Medicare baseline (a markup of 1188%). 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
Healthnet Federal-All Plans	$70	827%
Humana	$70	827%
Medica Prime Solutions-All Plans	$70	827%
Pacific Source Mcr Adv	$70	827%
Triwest-All Plans	$70	827%
Amish Old Orders-All Plans	$86	1017%
Allegiance Provider-All Plans	$97	1147%
6 Degrees Health-All Plans	$109	1288%
Americas Choice-All Plans	$109	1288%
Community Health Ntwk-All Plans	$109	1288%
Fedmed Network-All Plans	$109	1288%
First Choice Big Sky-All Plans	$109	1288%
Interwest Ppo-All Plans	$109	1288%
Mountain Health Co-Op-All Plans	$109	1288%
Pacific Source-All Other Plans	$109	1288%
Pacific Steel & Recycling-All Plans	$109	1288%
Rocky Mountain Health Network-All Plans	$109	1288%
Three Rivers-All Plans	$109	1288%
First Health-All Plans	$110	1300%
Ccn-All Plans	$111	1312%
UnitedHealthcare	$112	1324%
City Of Billings-All Plans	$172	2033%

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 $114.
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 Wheatland Memorial Hospital 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.