CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Mercy St Francis Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $197
Cash Discount Price: $142
vs. Medicare Baseline: 23.29x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Mercy St Francis Hospital is $197. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $142. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 23.29x the Medicare baseline. Located in 100 West Highway 60, Po Box 82, Mountain View, MO.

Cash / Self-Pay

$142

Average discount available for prompt cash payment at this facility.

Insurance Median

$197

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: $142 (1678%)

Insurance Median: $197 (2329%)

Cash: $142 (1678% of Medicare)

Ins. Median: $197 (2329% 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 2329% of the Medicare baseline (a markup of 2229%). 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
Medicaid / KanCare	$8 - $114	95%
Blue Cross Blue Shield	$8 - $212	95%
Medicare (plans)	$9 - $78	106%
UnitedHealthcare	$12 - $208	142%
Globalhealth Contracted [320145]	$60 - $75	709%
Medical Associates Health Contracted [320444]	$60 - $75	709%
Cross Timbers Hospice [20098]	$60 - $75	709%
Pace of the Ozarks Contracted [320518]	$60 - $75	709%
Humana	$60 - $197	709%
Mercy Mgd Behavioral Health Contracted [320259]	$60 - $75	709%
Qual Choice Contracted [320325]	$60 - $75	709%
Acentra Health Contracted [320527]	$60	709%
Halo Hcr Inc Hospice [20432]	$60 - $75	709%
Cigna	$60 - $208	709%
Kindful Hospice [20434]	$60 - $75	709%
Cherokee Nation Health Serv Contracted [320066]	$60 - $75	709%
Halo Hcr Inc Hospice Contracted [320432]	$60 - $75	709%
Indian Health Service Contracted [320198]	$60 - $75	709%
Mercy Hospice Okc [20252]	$60 - $75	709%
Kindful Hospice Contracted [320434]	$60 - $75	709%
Provider Partners Health Plans Contracted [320450]	$60 - $75	709%
Elara Caring Aspire Hospice [20433]	$60 - $75	709%
Dept of Veteran Affairs Contracted [320106]	$60 - $75	709%
Aetna	$60 - $195	709%
Tricare	$74	875%
Healthscope Contracted [320182]	$75 - $100	887%
Centivo Contracted [320505]	$99 - $127	1170%
Administrative Payor Contracted [320005]	$99	1170%
Home State Health Plan Contracted [320187]	$114	1348%
Ambetter / Centene	$114	1348%
Novasys Contracted [320285]	$114	1348%
Healthlink Contracted [320179]	$142 - $208	1678%
Preferred Health Plan Contracted [320522]	$142	1678%
Workers Comp [20426]	$175 - $186	2069%
Point C Contracted [320238]	$197 - $208	2329%
Mercy Benefit Admin Contracted [320251]	$197 - $208	2329%
United Medical Resources Contracted [320454]	$197 - $204	2329%
Auxiant Contracted [320462]	$197 - $208	2329%
Medica Contracted [320239]	$207	2447%
Insurance System Inc Contracted [320465]	$208	2459%
First Health Contracted [320128]	$208	2459%
90 Degree Benefits Contracted [320436]	$208	2459%
Health Systems Inc Contracted [320174]	$208	2459%
Show-Me Health Administrators Contracted [320483]	$208	2459%
Reflect Health Contracted [320492]	$208	2459%
Edison Health Solutions Contracted [320502]	$208	2459%
USA Managed Care Org Contracted [320429]	$208	2459%
Yuzu Health Contracted [320521]	$208	2459%
Multiplan Contracted [320270]	$208	2459%
Imagine 360 Contracted [320494]	$208	2459%
Private Health Care Systems Contracted [320320]	$208	2459%
Point C [20238]	$208	2459%
Evolutions Health Care Contracted [320124]	$208	2459%
Benefit Management Contracted [320052]	$208	2459%
Ebms Contracted [320493]	$208	2459%
Aither Health Contracted [320449]	$208	2459%

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 $142.
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 Mercy St Francis Hospital 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.