CMS Price Transparency Data

Blood test, potassium

Facility: HSHS St Elizabeth's Hospital

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84132
  • Insurance Median: $71
  • Cash Discount Price: $64
  • vs. Medicare Baseline: 14.92x Medicare
The contracted insurance negotiated median rate for a Blood test, potassium at HSHS St Elizabeth's Hospital is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $64. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 14.92x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$64

Average discount available for prompt cash payment at this facility.

Insurance Median
$71

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: $64 (1345%)
Insurance Median: $71 (1492%)
Cash: $64 (1345% of Medicare)
Ins. Median: $71 (1492% 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 1492% of the Medicare baseline (a markup of 1392%). 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
Meridian Health Plan $4 84%
Molina Healthcare $4 - $5 84%
Aetna $5 - $63 105%
Blue Cross Blue Shield $5 - $89 105%
Clear Spring Health Of Illinois $5 105%
Health Alliance Medical Plans $5 - $76 105%
Health Partners $5 105%
Humana $5 105%
Sae Hospice $5 105%
UnitedHealthcare $5 - $89 105%
Celtic Insurance Company $10 210%
Naphcare $11 231%
Claim Doc $12 252%
Hopetrust $12 252%
Amish Community $25 525%
Wellfirst $57 1197%
First Health $66 1387%
Cigna $70 - $89 1471%
Caterpillar, Inc. $71 1492%
Healthlink $71 - $89 1492%
Consociate Group $78 1639%
Choicecare $80 1681%
Healthcare Finest Network (Hfn) $80 1681%
Multiplan/Phcs $80 1681%
Provider Network Of America $80 1681%
City Of Springfield $89 1870%
Current Health Solutions $89 1870%
Healthscope $89 1870%
Illinois Breast And Cervical Cancer Program $89 1870%
Interplan $89 1870%
Live360 $89 1870%
Wexford $89 1870%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals