Blood test, basic metabolic panel
Facility: Wamego Health Center
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $9
- Cash Discount Price: $32
- vs. Medicare Baseline: 1.06x 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 |
|---|---|---|
| Providrs Care | $8 | 95% |
| UnitedHealthcare | $8 | 95% |
| Medicaid / KanCare | $9 | 106% |
| Aetna | $9 | 106% |
| Blue Cross Blue Shield | $68 - $72 | 804% |
Consumer Guidance & Cost Commentary
For the basic metabolic panel blood test at Wamego Health Center, the cash median price is $32.00, which is significantly lower than the facility's negotiated rates of $9.00 and the Medicare benchmark of $8.46. While the facility is a Critical Access Hospital in Wamego, KS, patients with high-deductible plans may find paying cash directly more affordable than relying on insurance, as commercial negotiated rates often exceed cash prices due to administrative overhead. It is important to note that while the facility lists a gross charge of $80.00, the actual cost to the patient depends heavily on their specific insurance plan; however, since the cash price is already below the Medicare rate, paying out-of-pocket avoids the potential for balance billing if an out-of-network provider were involved, though the No Surprises Act protects emergency care at in-network facilities.
Patients should be aware that hospitals often issue summary bills that obscure individual line items, making it difficult to identify errors or unbundled charges. To ensure you are not overcharged, request a full itemized CPT-coded bill before paying, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute. Additionally, if you choose to pay cash, ask the billing department about prompt-pay discounts, which can reduce the $32.00 cash median by 20% to 50% if settled within 30 days, bypassing the costly claims processing cycle that inflates insurance rates. Always verify your deductible status before scheduling, as paying the full negotiated rate without meeting your deductible can result in higher out-of-pocket costs than the cash option.