CMS Price Transparency Data

Blood test, potassium

Facility: Adventist Health Sonora

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84132
  • Insurance Median: $56
  • Cash Discount Price: $18
  • vs. Medicare Baseline: 11.76x Medicare
The contracted insurance negotiated median rate for a Blood test, potassium at Adventist Health Sonora is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 11.76x the Medicare baseline. Located in 1000 Greenley Road, Sonora, CA.
Cash / Self-Pay
$18

Average discount available for prompt cash payment at this facility.

Insurance Median
$56

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$4.76

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.76 (100%)
Cash / Self-Pay: $18 (378%)
Insurance Median: $56 (1176%)
Cash: $18 (378% of Medicare)
Ins. Median: $56 (1176% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $4.76 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 1176% of the Medicare baseline (a markup of 1076%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Kaiser - All Plans $2 - $176 42%
UnitedHealthcare $2 - $303 42%
Western Growers/Pinnacle - All Plans $2 - $187 42%
Affordable Health - All Plans $3 - $317 63%
Beech Street- All Plans $3 - $299 63%
Blue Shield - All Other Plans $3 - $268 63%
Blue Shield Epn $3 - $267 63%
Celtic Ca Hlth Well Mcal - All Plans $3 - $7 63%
Central Ca Alliance Ccs Mcal $3 - $6 63%
Central Ca Alliance Chdp Mcal $3 - $6 63%
Central Ca Alliance Mcal $3 - $6 63%
Cigna $3 - $334 63%
Greatwest Oa/Pos/Hmo $3 - $299 63%
Greatwest Ppo - All Other Plans $3 - $317 63%
Healthnet - All Other Plans $3 - $308 63%
Healthnet Mcal $3 - $7 63%
Interplan - All Plans $3 - $317 63%
Medi-Cal $3 - $5 63%
Multiplan - All Plans $3 - $317 63%
Phcs Ppo - All Plans $3 - $317 63%
Stanilaus Foundation - All Plans $3 - $334 63%
Trpn - Three Rivers Ppo - All Plans $3 - $282 63%
Aetna $5 - $47 105%
Blue Shield Mcare $5 105%
Healthnet Mcr Adv $5 105%
Phs Prime Health Srvcs-All Plans $5 105%
Tricare $5 105%
Ah Employee Health Plan - All Plans $9 189%
Bc Exchange $42 882%
Bc Non-Mcs - All Other Plans $47 987%
Bc Mcs $56 1176%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Greenley Road, Sonora, CA 95370
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals