CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Wilkes Regional Medical Center

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $28
  • Cash Discount Price: $27
  • vs. Medicare Baseline: 3.31x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Wilkes Regional Medical Center is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 3.31x the Medicare baseline. Located in 1370 West D St, North Wilkesboro, NC.
Cash / Self-Pay
$27

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

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: $27 (319%)
Insurance Median: $28 (331%)
Cash: $27 (319% of Medicare)
Ins. Median: $28 (331% 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 331% of the Medicare baseline (a markup of 231%). 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.

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
Healthteam $9 106%
Alliance $15 177%
Amerihealth $15 - $31 177%
Carolina Complete $15 177%
Healthblue $15 177%
Partners $15 177%
Trillium $15 177%
UnitedHealthcare $15 - $29 177%
Vaya $15 177%
Wellcare $15 177%
Medcost $16 - $39 189%
Aetna $21 - $37 248%
Blue Cross Blue Shield $21 - $32 248%
Ambetter / Centene $25 - $33 296%
Cigna $28 - $29 331%
Oscar $30 - $35 355%
Directnet $32 378%
Private Healthcare Systems $49 579%
Multiplan $50 591%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1370 West D St, North Wilkesboro, NC 28659
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals