How can I find out the cost of a medical procedure?

To find out the cost of a medical procedure, you should first obtain the specific CPT (Current Procedural Terminology) code from your doctor or healthcare provider. Once you have the CPT code and your specific location, you can use online tools to look up pricing. For accurate fee schedule lookups tailored to your location and CPT code, it's recommended to use services like Payerprice. They offer a fee schedule lookup tool for users to search with CPT code and specific location. You should also contact your insurance provider directly to understand your out-of-pocket expenses, deductibles, and co-pays, as these will affect your final cost.

A CPT (Current Procedural Terminology) code is a standardized five-digit code used by healthcare providers to describe medical, surgical, and diagnostic services. These codes are essential for accurate billing and to facilitate communication about medical procedures between providers, patients, and insurance companies. When looking up the cost of a specific procedure, having its CPT code will allow you to get the most accurate pricing information, for example, by using a tool like Payerprice.

Why do healthcare costs vary so much?

Healthcare costs can vary significantly due to a multitude of factors. These include the geographic location of the provider, the type of facility (e.g., hospital vs. independent clinic), the specific insurance plan you have, the negotiated rates between providers and insurers, the complexity of the procedure, and even differences in overhead costs. These variations make it challenging for consumers to predict costs, highlighting the importance of using tools like Payerprice to research pricing for specific CPT codes in your area.

Is there a way to compare prices before I get care?

Yes, there are ways to compare prices before receiving care. The most effective method is to obtain the CPT code for your anticipated procedure from your healthcare provider. With this code and your location, you can then utilize online price transparency tools. Payerprice, for instance, offers a fee schedule lookup tool where you can search by CPT code and location to get an estimate of costs. Additionally, contacting your insurance company directly can help you understand what your specific plan will cover and what your out-of-pocket responsibility will be.

What's the difference between my out-of-pocket maximum and deductible?

Your deductible is the amount you must pay for covered healthcare services before your insurance plan starts to pay. For example, if your deductible is $1,000, you pay the first $1,000 of covered services yourself. Your out-of-pocket maximum is the most you have to pay for covered services in a plan year. After you reach this limit, your health plan pays 100% of the costs of covered benefits. The deductible contributes to the out-of-pocket maximum, but co-pays and co-insurance also contribute to the out-of-pocket maximum even after the deductible is met.

CPT 80048 Fee Schedule

Q: What factors affect fee schedules?

Fee schedules are affected by Medicare & Medicaid Rates (government-set reimbursement amounts), Private Insurance Rates (negotiated rates between providers and insurance companies), Geographic Location (costs may be higher in urban areas), and Provider Type (hospital providers may have different rates than private practice).

Q: How does CPT 80048 compare to other Organ or Disease Oriented Panels Codes?

The CPT 80048 code is part of the Pathology and Laboratory Procedures services used for Organ or Disease Oriented Panels. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements. The CPT 80048 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

Last Verified: July 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Basic Metabolic Pnl Total Ca, Basic Metabolic Panel (Calcium Total) This Panel Must Include The Following: Calcium Total (82310) Carbon Dioxide (Bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium (84132) Sodium (84295) Urea Nitrogen (Bun) (84520)

Key Fact	Detail
Service Type	Organ or Disease Oriented Panels Pathology and Laboratory Procedures
Common Place of Service	81 - Independent Laboratory 21 - Inpatient Hospital
Common Modifiers	None 26 - Professional component QW - CLIA Waived Tests
Complexity Level	Low
Medicare Fee Schedule	View Medicare rates for 80048

National average reimbursement for CPT 80048 by major payers:

$7.68

$5.95

$10.73

$12.64

Preview provider-level rates for...

For billing codeCPT 80048

Payer	Code	Rate	NPI	Tax ID	State	Specialty
United	80048	$3.54	1407863871 - MICHAEL LIPNICK	841037195 - (CO) PONDEROSA FAMILY PHYSICIANS, P.C	CO	Family Medicine Physician (207Q00000X)
United	80048	$4.86	1265607485 - DAVID STENSTROM	621766695	CO	Internal Medicine Physician (207R00000X)
United	80048	$3.54	1942629373 - SAI ANANDI RAMASWAMI	841343242	CO	Internal Medicine Physician (207R00000X)
United	80048	$21.77	1518943554 - MAUREEN KELLY	954806004	CO	Internal Medicine Physician (207R00000X)
United	80048	$3.54	1295897528 - JOYCE MOBLEY	271882094 - (TN) LIFE CARE PHYSICIAN SERVICES LLC	CO	Family Medicine Physician (207Q00000X)
United	80048	$5.03	1205860202 - TIMOTHY BRESNAHAN	271823362 - (CO) RED MOUNTAIN INTERNAL MEDICINE	CO	Internal Medicine Physician (207R00000X)
United	80048	$3.54	1588944516 - MARK CHRISTENSEN	364778373 - (CO) ONPOINT MEDICAL GROUP, LLC	CO	Family Medicine Physician (207Q00000X)
United	80048	$3.54	1174629919 - ANDREW WILLIAMS	10758652	CO	Internal Medicine Physician (207R00000X)
United	80048	$17.14	1568791333 - LABORATORY CORPORATION OF AMERICA	840611484	CO	Clinical Medical Laboratory (291U00000X)
United	80048	$4.88	1912050295 - PATRICK KEARNEY	383687269 - (CO) DURANGO FAMILY MEDICINE P C	CO	Family Medicine Physician (207Q00000X)
United	80048	$46.43	1851595003 - MICHAEL PETERS	943281657	CO	Internal Medicine Physician (207R00000X)
United	80048	$8.46	1548345101 - WILLIAM KUBASKA	841509751 - (CO) ROSE INTERNAL MEDICINE DIABETES	CO	Internal Medicine Physician (207R00000X)
United	80048	$3.54	1619950201 - MICHAEL PRAMENKO	840425720 - (CO) ST MARYS HOSPITAL AND MEDICAL CENTER INC	CO	Family Medicine Physician (207Q00000X)
United	80048	$3.54	1952930216 - MOLLY MCLELLAN	841262971 - (CO) POUDRE VALLEY HEALTH CARE INC	CO	Family Medicine Physician (207Q00000X)
United	80048	$3.54	1508009929 - DAVID ZIEGLER	742161737 - UNIVERSITY PHYSICIANS INCORPORATED	CO	Family Medicine Physician (207Q00000X)
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist

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CPT 80048 vs. Other Pathology and Laboratory Procedures Codes

The CPT 80048 code is part of the Organ or Disease Oriented Panels services used for Pathology and Laboratory Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 80048 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

Code	Complexity	Description
80047-CPT	Low	Basic Metablc Pnl Ionized Ca, Basic Metabolic Panel (Calcium Ionized) This Panel Must Include The Following: Calcium Ionized (82330) Carbon Dioxide (Bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium (84132) Sodium (84295) Urea Nitrogen (Bun) (84520)
80048-CPT	Low	Basic Metabolic Pnl Total Ca, Basic Metabolic Panel (Calcium Total) This Panel Must Include The Following: Calcium Total (82310) Carbon Dioxide (Bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium (84132) Sodium (84295) Urea Nitrogen (Bun) (84520)
80051-CPT	Low	Electrolyte Testing, An Electrolyte Panel Is A Blood Test That Measures Levels Of Sodium Potassium Chloride And Bicarbonate In The Blood. It Commonly Helps Monitor Medication Effects And Evaluate Kidney Function.
80053-CPT	Low	Comprehen Metabolic Panel, Comprehensive Metabolic Panel This Panel Must Include The Following Albumin 82040 Bilirubin Total 82247 Calcium Total 82310 Carbon Dioxide Bicarbonate 82374 Chloride 82435 Creatinine 82565 Glucose 82947 Phosphatase Alkaline 84075 Potassium 84132 Protein Total 84155 Sodium 84295 Transferase Alanine Amino Alt Sgpt 84460 Transferase Aspartate Amino Ast Sgot 84450 Urea Nitrogen Bun 84520

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 80048. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 80048 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules

Medicare & Medicaid Rates

Government-set reimbursement amounts

Private Insurance Rates

Negotiated rates between providers and insurance companies

Geographic Location

Costs may be higher in urban areas.

Provider Type

Hospital providers may have different rates than private practice.

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