CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Pawhuska Hospital, Inc

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $136
Cash Discount Price: $104
vs. Medicare Baseline: 16.08x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Pawhuska Hospital, Inc is $136. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $104. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 16.08x the Medicare baseline. Located in 1101 East 15Th Street, Pawhuska, OK.

Cash / Self-Pay

$104

Average discount available for prompt cash payment at this facility.

Insurance Median

$136

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: $104 (1229%)

Insurance Median: $136 (1608%)

Cash: $104 (1229% of Medicare)

Ins. Median: $136 (1608% 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 1608% of the Medicare baseline (a markup of 1508%). 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
Healthchoice Ip/Op Only - All Plans	$14	165%
UnitedHealthcare	$15 - $133	177%
Community Care Comm - All Plans	$21	248%
Blue Cross Blue Shield	$91 - $157	1076%
Aetna	$101 - $185	1194%
Tricare	$101 - $107	1194%
Wellcare Mcr Adv - All Plans	$101 - $107	1194%
Humana	$102 - $185	1206%
Healthcare Highways - All Plans	$113 - $120	1336%
Cigna	$118 - $126	1395%
Multiplan - All Plans	$130 - $139	1537%
Ambetter / Centene	$151 - $161	1785%
Preferred Commchoice Ip/Op Only - All Plans	$157 - $166	1856%
Soonerselect Mcaid - All Plans	$174 - $185	2057%

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 $104.
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 Pawhuska Hospital, Inc 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.