Blood test, basic metabolic panel
Facility: Susan B Allen Memorial Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $554
- Cash Discount Price: $21
- vs. Medicare Baseline: 65.48x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 6548% of the Medicare baseline (a markup of 6448%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $350 | 4137% |
| Providrs Care | $757 | 8948% |
Consumer Guidance & Cost Commentary
For the basic metabolic panel blood test at Susan B Allen Memorial Hospital in El Dorado, KS, the cash median price is $21.00, which is significantly lower than the negotiated rates of $350 and $757 charged by UnitedHealthcare and Providrs Care, respectively. While the facility's cash rate is notably lower than its own negotiated amounts, it is important to note that commercial insurance contracts often result in higher final costs for patients due to administrative fees and network tiering. In this specific case, the cash price is also lower than the Medicare benchmark of $8.46, suggesting that for patients with high-deductible plans or those without insurance, paying out-of-pocket may be the most cost-effective option compared to relying on insurance coverage for this service.
Patients should be aware that hospitals frequently offer prompt-pay discounts for self-pay patients who settle their bill upfront, which can further reduce the $21.00 cash median. If you have insurance, verify your specific plan's deductible status before scheduling, as you may be responsible for the full negotiated amount if your deductible has not been met. Additionally, if you encounter a balance bill after receiving care, remember that the No Surprises Act protects you from being billed for out-of-network services at in-network facilities, and you should request an itemized audit to identify any unbundled codes or services not rendered before agreeing to pay the full amount.