CMS Price Transparency Data

Blood test, potassium

Facility: Decatur Memorial Hospital

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84132
Insurance Median: $26
Cash Discount Price: $45
vs. Medicare Baseline: 5.46x Medicare

The contracted insurance negotiated median rate for a Blood test, potassium at Decatur Memorial Hospital is $26. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 5.46x the Medicare baseline. Located in 2300 North Edward Street, Decatur, IL.

Cash / Self-Pay

$45

Average discount available for prompt cash payment at this facility.

Insurance Median

$26

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: $45 (945%)

Insurance Median: $26 (546%)

Cash: $45 (945% of Medicare)

Ins. Median: $26 (546% 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 546% of the Medicare baseline (a markup of 446%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$4 - $49	84%
Aetna	$5 - $33	105%
Coventry	$5 - $25	105%
Health Alliance	$5 - $33	105%
Humana	$5 - $32	105%
Medicare (plans)	$5	105%
Tricare	$5	105%
UnitedHealthcare	$5 - $49	105%
Veterans Administration	$5	105%
Wellcare	$5	105%
Caterpillar	$6	126%
Medicaid / KanCare	$6	126%
Plain Church Medical Group	$6 - $22	126%
Mennonite Churches	$14 - $17	294%
Health Alliance Mh Employee Plan	$18 - $23	378%
Cigna	$19 - $23	399%
Illinois Workers Compensation	$23 - $33	483%
6 Degrees Health	$24 - $29	504%
Hopetrust	$24 - $29	504%
Hst	$24 - $29	504%
Phcs Savility	$26 - $32	546%
Healthlink	$27 - $34	567%
Phcs Multiplan Ppo	$27 - $33	567%
Corvel	$29 - $35	609%
Consociate	$30 - $36	630%
Hfn	$30 - $37	630%
Commercial Workers Compensation	$32	672%
Liability	$40 - $49	840%

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 $45.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84132.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Decatur Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 84132.
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.