CMS Price Transparency Data

Blood test, potassium

Facility: Madison County Health Care System

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84132
  • Insurance Median: $23
  • Cash Discount Price: $26
  • vs. Medicare Baseline: 4.83x Medicare
The contracted insurance negotiated median rate for a Blood test, potassium at Madison County Health Care System is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $26. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 4.83x the Medicare baseline. Located in 300 West Hutchings Street, Winterset, IA.
Cash / Self-Pay
$26

Average discount available for prompt cash payment at this facility.

Insurance Median
$23

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: $26 (546%)
Insurance Median: $23 (483%)
Cash: $26 (546% of Medicare)
Ins. Median: $23 (483% 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 483% of the Medicare baseline (a markup of 383%). 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
Aetna $14 - $21 294%
Medical Associates Hp - All Plans $14 294%
Medigold-All Plans $14 294%
Tricare $14 294%
UnitedHealthcare $14 - $30 294%
American Hp Mcr Adv-All Plans $15 315%
Amerigroup Mcaid-All Plans $16 336%
Iowa Total Care Mcaid-All Plans $16 336%
Madison County Sheriff-All Plans $16 336%
Molina Mcaid/Chip -All Plans $16 336%
Blue Cross Blue Shield $20 - $23 420%
Oscar - All Plans $21 441%
Corvel Wc-All Plans $30 630%
Choicecare-All Plans $31 651%
First Choice-All Plans $31 651%
First Health-All Plans $31 651%
Integrated Hp-All Plans $31 651%
Mutual Of Omaha-All Plans $31 651%
Plaines Health-All Plans $31 651%
Preferred Hlth Ntwork-All Plans $31 651%
Principal Healthcare-All Plans $31 651%
Usa Managed Care-All Plans $31 651%
Medimore Employee Hp - All Plans $32 672%
Midlands Choice - All Plans $32 672%
Benefit Admin Of America-All Plans $33 693%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 West Hutchings Street, Winterset, IA 50273
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals