CMS Price Transparency Data

Blood test, potassium

Facility: Woodlawn Hospital

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84132
Insurance Median: $16
Cash Discount Price: $55
vs. Medicare Baseline: 3.36x Medicare

The contracted insurance negotiated median rate for a Blood test, potassium at Woodlawn Hospital is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $55. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 3.36x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.

Cash / Self-Pay

$55

Average discount available for prompt cash payment at this facility.

Insurance Median

$16

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: $55 (1155%)

Insurance Median: $16 (336%)

Cash: $55 (1155% of Medicare)

Ins. Median: $16 (336% 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 336% of the Medicare baseline (a markup of 236%). 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	$2 - $55	42%
Partners Direct Health-All Plans	$3	63%
UnitedHealthcare	$3 - $55	63%
Caresource Mcaid Hww	$5	105%
Mdwise Excel Hhw & Hcc	$5	105%
Mhs Mcaid Hcc	$5	105%
Mhs Mcaid Hhw	$5	105%
Aetna	$16 - $69	336%
Caresource Mcaid Hip	$16	336%
Caresource Mcr Adv	$16	336%
Humana	$16 - $57	336%
Mdwise Mcaid Excel Hip	$16	336%
Mhs Exch Mrktplce-All Other Plans	$16	336%
Mhs Mcaid Hip	$16	336%
Mhs Mcr Adv	$16	336%
Ambetter / Centene	$21	441%
Caresource Exch - All Other Plans	$21	441%
Cigna	$52 - $62	1092%
Parkview Health Plans-All Plans	$55	1155%
Sagamore All Other Grps - All Other Plans	$61	1282%
Encore Comm-All Plans	$62	1303%
Phcs/Multiplan-All Plans	$68	1429%
Community Health Alliance-All Plans	$69	1450%

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 $55.
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 Woodlawn 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.