Blood test, basic metabolic panel
Facility: Oakleaf Surgical Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $8
- Cash Discount Price: $82
- 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 |
|---|---|---|
| Blue Cross Blue Shield | $8 | 95% |
| Dean Health Plan | $8 | 95% |
| Group Health Cooperative Of Eau Claire | $8 | 95% |
| Healthpartners | $8 | 95% |
| Humana | $8 | 95% |
| Medica | $8 | 95% |
| Quartz Health Solutions | $8 | 95% |
| Security Health Plan Of Wi | $8 | 95% |
| Ucare Wi | $8 | 95% |
| UnitedHealthcare | $8 | 95% |
Consumer Guidance & Cost Commentary
For this blood test at Oakleaf Surgical Hospital in Altoona, WI, the most significant pricing metric is the Medicare benchmark of $8.46, which serves as the objective baseline for evaluating commercial rates. While the facility's gross charge is listed at $91, the actual negotiated rate paid by commercial payers is $8, and the median paid rate is $72. This data highlights a substantial difference between the hospital's list price and the amount commercial insurers actually remit, illustrating why comparing against the Medicare rate rather than the chargemaster is essential for understanding true costs.
Patients should note that the facility's cash price of $82 is significantly higher than the commercial negotiated rate of $8, which may present an opportunity for cost savings if a patient has a high deductible plan where the insurance allowed amount exceeds the cash price. However, since the facility is physician-owned and located in a state where commercial rates often deviate from cash, it is advisable to verify "self-pay" or "prompt-pay" discounts directly with the hospital before scheduling. Additionally, because commercial rates can vary by payer and administrative structures often inflate baseline prices by 20% to 40%, consumers should request an itemized billing audit to ensure no errors, double-billing, or unbundled codes are included in the final statement.