CMS Price Transparency Data

Blood test, potassium

Facility: Saint Joseph Regional Medical Center - Plymouth

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84132
  • Insurance Median: $35
  • Cash Discount Price: $46
  • vs. Medicare Baseline: 7.35x Medicare
The contracted insurance negotiated median rate for a Blood test, potassium at Saint Joseph Regional Medical Center - Plymouth is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 7.35x the Medicare baseline. Located in 1915 Lake Ave, Plymouth, IN.
Cash / Self-Pay
$46

Average discount available for prompt cash payment at this facility.

Insurance Median
$35

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: $46 (966%)
Insurance Median: $35 (735%)
Cash: $46 (966% of Medicare)
Ins. Median: $35 (735% 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 735% of the Medicare baseline (a markup of 635%). 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 $3 - $35 63%
Blue Cross Blue Shield $3 - $10 63%
Medicaid / KanCare $3 - $5 63%
UnitedHealthcare $3 - $45 63%
County Coroner $5 105%
Managed Health Services - Indiana $5 105%
Mdwise $5 105%
Medicare (plans) $5 105%
Meridian Complete $5 105%
Pace-Trinity Health $5 105%
Provider Partners Health Plan Of Indiana $5 105%
Auxiant $7 - $59 147%
Caresource $7 147%
Physicians Health Plan Northern Indiana Health Insurance $7 - $14 147%
St Joseph County Hlth Dpt $7 147%
Siho Insurance Services $8 168%
Allied Benefit Systems $9 - $46 189%
Key Benefit Administrator $9 - $50 189%
Blue Benefit Administrators Of Massachusetts $10 210%
Blue Care Network $10 210%
Blue Distinction Transplant $10 210%
Blue Shield - Ca $10 210%
Blue Shield - Id (Regence) $10 210%
Blue Shield - Ny Highmark Northeastern $10 210%
Blue Shield - Ny Highmark Western $10 210%
Blue Shield - Pa (Highmark) $10 210%
Blue Shield - Wa (Regence) $10 210%
Custom Design Benefits $10 210%
Plain Church Group $19 399%
Asr Health Benefits $35 735%
Christian Brother Services $35 735%
Employee Benefit Management $35 735%
Medical Mutual $35 735%
Meritain $35 735%
Preferred One $35 735%
Rural Carrier Health Benefit Plan $35 735%
Webtpa $35 735%
Notre Dame Athletic Association $39 819%
Wc Notre Dame $39 819%
Luminare Health (Detroit) $40 - $43 840%
Ameriben $43 903%
Geha $45 945%
Healthscope $45 945%
Student Insurance Cma $45 945%
Encore Health $50 1050%
Indiana Criminal Justice Inst $50 1050%
Western & Southern Financial Group $50 1050%
Cigna $51 1071%
Group Administrators $51 1071%
Health Partners $51 1071%
Mvp $51 1071%
Prairie States $51 1071%
Priority Health $51 1071%
Professional Benefit Administrators $51 1071%
Sagamore Health Network $51 - $55 1071%
Sisco Benefits $51 1071%
Unified Group Services $51 1071%
Goshen Preferred Network $55 - $61 1155%
Signature Care $59 1239%
Allied National Global Care $64 1345%
Asrm - Reliance Standard Life Insurance $64 1345%
Avmed Health Plan $64 1345%
Christian Care Ministry $64 1345%
Dean Health $64 1345%
Fallon Health $64 1345%
Family Life Insurance Company $64 1345%
Freedom Life Insurance Company $64 1345%
Ghc Scw $64 1345%
International Benefit Administrators $64 1345%
Lifetime Benefit Solutions $64 1345%
Manhattan Life $64 1345%
Medi Share $64 1345%
Multiplan $64 1345%
Pai $64 1345%
Pan-American Life $64 1345%
Paramount Hmo $64 1345%
Phcs $64 1345%
Philadelphia American Life Insurance $64 1345%
Trinity Health Share $64 1345%
Bankers Life Casualty $71 1492%
Bureau Of Disability $71 1492%
Wc Align Network $71 1492%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1915 Lake Ave, Plymouth, IN 46563
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals