CMS Price Transparency Data

Blood test, potassium

Facility: Nemours Children's Hospital, Delaware

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84132
  • Insurance Median: $64
  • Cash Discount Price: $141
  • vs. Medicare Baseline: 13.45x Medicare
The contracted insurance negotiated median rate for a Blood test, potassium at Nemours Children's Hospital, Delaware is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $141. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 13.45x the Medicare baseline. Located in 1600 Rockland Rd Po Box 269, Wilmington, DE.
Cash / Self-Pay
$141

Average discount available for prompt cash payment at this facility.

Insurance Median
$64

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: $141 (2962%)
Insurance Median: $64 (1345%)
Cash: $141 (2962% of Medicare)
Ins. Median: $64 (1345% 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 1345% of the Medicare baseline (a markup of 1245%). 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.

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
Priority Partners John Hopkins $5 - $105 105%
Tricare $5 105%
Us Family Health Plan $6 126%
Celtic Transplant $8 - $215 168%
Keystone First Hlth Plan $13 - $95 273%
Celtic Transplant For De First Health $23 - $75 483%
Blue Cross Blue Shield $24 - $190 504%
Kidz Partners $25 - $81 525%
UnitedHealthcare $25 - $134 525%
Wellpoint Maryland $25 - $80 525%
Health Partners $26 - $83 546%
Fidelis $27 - $86 567%
Upmc $27 - $85 567%
Aetna $28 - $125 588%
Six Degrees Health Transplant $34 - $108 714%
Cigna $37 - $135 777%
Great West-One Health Plan $37 - $135 777%
Ambetter / Centene $38 - $123 798%
Amerihealth Caritas Delaware $38 - $123 798%
Geisinger Health Plan $40 - $129 840%
Integra Administrative Group $40 - $129 840%
National Transplant Network (Ntn) $44 - $140 924%
Six Degrees Health $44 - $140 924%
Star Healthcare Network $44 - $140 924%
Life Trac Solid Organ And Bmt Transplant $47 - $150 987%
First Health Network $64 - $204 1345%
Insurance Administrators Of America $64 - $204 1345%
Interlink Transplant Network $64 - $204 1345%
Multiplan $64 - $204 1345%
Preferred Healthcare $64 - $204 1345%
Private Healthcare Systems $64 - $204 1345%
Three Rivers Provider Network $64 - $204 1345%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Rockland Rd Po Box 269, Wilmington, DE 19899
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens