CMS Price Transparency Data

Blood test, potassium

Facility: Mercy Hospital Pittsburg, Inc

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84132
  • Insurance Median: $8
  • Cash Discount Price: $44
  • vs. Medicare Baseline: 1.68x Medicare
The contracted insurance negotiated median rate for a Blood test, potassium at Mercy Hospital Pittsburg, Inc is $8. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 1.68x the Medicare baseline. Located in 1 Mt Carmel Way, Pittsburg, KS.
Cash / Self-Pay
$44

Average discount available for prompt cash payment at this facility.

Insurance Median
$8

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: $44 (924%)
Insurance Median: $8 (168%)
Cash: $44 (924% of Medicare)
Ins. Median: $8 (168% 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.

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
UnitedHealthcare $4 - $46 84%
Medicaid / KanCare $4 - $8 84%
Aetna $4 - $58 84%
Humana $4 - $5 84%
Blue Cross Blue Shield $4 - $12 84%
Kindful Hospice [20434] $5 105%
Kindful Hospice Contracted [320434] $5 105%
Halo Hcr Inc Hospice Contracted [320432] $5 105%
Medicare (plans) $5 105%
Halo Hcr Inc Hospice [20432] $5 105%
Pace Of The Ozarks Contracted [320518] $5 105%
Medica Contracted [320239] $5 105%
Dept Of Veteran Affairs Contracted [320106] $5 105%
Cross Timbers Hospice [20098] $5 105%
Mercy Hospice Okc [20252] $5 105%
Elara Caring Aspire Hospice [20433] $5 105%
American Health Advantage Of Ks Mcr Contracted [320508] $5 105%
Tricare $5 105%
Health Choice Contracted [320166] $6 126%
Ambetter / Centene $8 168%
Home State Health Plan Contracted [320187] $8 168%
Providrs Care Network Contracted [320484] $9 189%
Cigna $26 - $27 546%
United Medical Resources Contracted [320454] $46 966%
Auxiant Contracted [320462] $54 1134%
American Healthcare Alliance Contracted [320020] $54 1134%
Aither Health Contracted [320449] $54 1134%
Edison Health Solutions Contracted [320502] $54 1134%
Workers Comp [20426] $54 1134%
Ebms Contracted [320493] $54 1134%
Reflect Health Contracted [320492] $54 1134%
Yuzu Health Contracted [320521] $54 1134%
Healthlink Contracted [320179] $54 1134%
Mercy Benefit Admin Contracted [320251] $54 1134%
Imagine 360 Contracted [320494] $54 1134%
First Health Contracted [320128] $58 1218%

Consumer Guidance & Cost Commentary

For the blood test, potassium procedure (CPT 84132) at Mercy Hospital Pittsburg, Inc., the facility's cash median rate is $44.00, while the median negotiated rate paid by insurance plans is $8.00. This significant difference highlights that cash-paying patients may find it more cost-effective to pay the cash price directly, especially if their insurance deductible has not yet been met or if their plan's negotiated rate exceeds the cash price. The facility offers a prompt-pay discount for upfront payments, which can further reduce the final amount owed. Patients are encouraged to explicitly ask the hospital about self-pay or prompt-pay rates before scheduling to ensure they are not billed the full negotiated amount by their insurer.

The facility's pricing is evaluated against federal benchmarks, with a Medicare amount of $4.76 and a "vs Medicare" ratio of 1.7, indicating the commercial rates are higher than the government baseline. While the data does not provide specific state or county average comparisons for this specific code, the wide variation in negotiated rates across 36 different payers—from as low as $4 to as high as $54—demonstrates that commercial insurance contracts can result in vastly different out-of-pocket costs depending on the specific plan. To avoid unexpected balance billing, patients should request an itemized bill to verify that all charges align with their plan's allowed amount and dispute any discrepancies in writing.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Mt Carmel Way, Pittsburg, KS 66762
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals