CMS Price Transparency Data

Blood test, thyroid (TSH)

Facility: Adventist Health Clearlake

Billing Code: 84443 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84443
Insurance Median: $19
Cash Discount Price: $54
vs. Medicare Baseline: 1.13x Medicare

The contracted insurance negotiated median rate for a Blood test, thyroid (TSH) at Adventist Health Clearlake is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $54. Compared to the federal Medicare reimbursement reference rate of $16.8, this hospital’s rate is 1.13x the Medicare baseline. Located in 15630 18Th Ave - Hwy 53, Clearlake, CA.

Cash / Self-Pay

$54

Average discount available for prompt cash payment at this facility.

Insurance Median

$19

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$16.8

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $16.8 (100%)

Cash / Self-Pay: $54 (321%)

Insurance Median: $19 (113%)

Cash: $54 (321% of Medicare)

Ins. Median: $19 (113% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $16.8 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.

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
UnitedHealthcare	$2 - $470	12%
Blue Cross Blue Shield	$3 - $196	18%
Blue Shield Mcr Adv	$3 - $118	18%
Kaiser Mcr Adv	$3 - $118	18%
Tricare	$3 - $118	18%
Ah Employee Health Plan - All Plans	$6 - $236	36%
Aetna	$11 - $421	65%
Blue Shield Epn - All Other Plans	$11 - $432	65%
Blue Shield Non-Epn	$11 - $432	65%
Western Growers- All Plans	$11 - $422	65%
First Health- All Plans	$12 - $450	71%
Healthnet- All Plans	$12 - $462	71%
Cigna	$13 - $507	77%
Foundation- All Plans	$13 - $479	77%
Health Mgmt Network- All Plans	$13 - $479	77%
Humana	$13 - $479	77%
Interplan- All Plans	$13 - $507	77%
Kaiser- All Other Plans	$13 - $507	77%
Phcs- All Plans	$13 - $479	77%
Three Rivers Provider Network- All Plans	$13 - $507	77%
Bc Managed Mcal	$15 - $19	89%
Medi-Cal	$15 - $19	89%
Partnership Mcal - All Plans	$15 - $19	89%

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 $54.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84443.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health Clearlake is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 84443.
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.