CMS Price Transparency Data

Blood test, potassium

Facility: Northside Hospital Duluth

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84132
  • Insurance Median: $38
  • Cash Discount Price: $72
  • vs. Medicare Baseline: 7.98x Medicare
The contracted insurance negotiated median rate for a Blood test, potassium at Northside Hospital Duluth is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 7.98x the Medicare baseline. Located in 3620 Howell Ferry Road, Duluth, GA.
Cash / Self-Pay
$72

Average discount available for prompt cash payment at this facility.

Insurance Median
$38

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: $72 (1513%)
Insurance Median: $38 (798%)
Cash: $72 (1513% of Medicare)
Ins. Median: $38 (798% 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 798% of the Medicare baseline (a markup of 698%). 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
Institutional Gwinnett Os100 Discount $3 63%
Institutional Gwinnett Os100 Standard $3 63%
Fairly Group $4 84%
Aetna $5 - $19 105%
Bccp $5 105%
Blue Cross Blue Shield $5 - $67 105%
Caresource $5 - $36 105%
Cbww $5 105%
Champus Va $5 105%
Clear Springs Eon Health $5 105%
Clover Health $5 105%
Coventry $5 - $65 105%
Humana $5 105%
Institutional Gwinnett County Govt $5 105%
Kaiser $5 - $84 105%
Medicaid / KanCare $5 105%
Medicare (plans) $5 - $6 105%
Pruitt Health Premier $5 105%
Tricare $5 105%
UnitedHealthcare $5 - $15 105%
Va Ccn $5 105%
Wellcare $5 105%
Ambetter / Centene $6 - $21 126%
Amerigroup $6 - $16 126%
Corvel Workers Comp $7 147%
Employers Choice Network $7 147%
Oscar $7 147%
Streamline Imaging $7 147%
Georgia Workers Compensation $8 168%
Us Dept Of Labor Wc $8 168%
Cigna $15 - $60 315%
Northside Health Network $29 609%
Georgia Reproductive Specialists $38 798%
Medlien Healthcare Services $38 798%
Med Care Solutions $43 903%
Health One Alliance_Ppo $53 1113%
Quick Trip $53 1113%
Novanet_Ppo $67 1408%
Phcs $72 1513%
Beech Steet $82 1723%
Multiplan $82 1723%
Multiplan Workers Comp $82 1723%
Careiq $96 2017%
Dekalb_Department Of Health $96 2017%
Fifa $96 2017%
Institutional Marietta Surgery Center $96 2017%
Institutional Veterans Evaluation Services $96 2017%
Johnson Ferry Imaging $96 2017%
Marietta Dermatology Clinical Research Inc $96 2017%
Rabun County Boc $96 2017%
West Paces Imaging Agreement $96 2017%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3620 Howell Ferry Road, Duluth, GA 30096
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals