CMS Price Transparency Data

Blood test, thyroid (TSH)

Facility: Mercy Hospital Pittsburg, Inc

Billing Code: 84443 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84443
  • Insurance Median: $28
  • Cash Discount Price: $138
  • vs. Medicare Baseline: 1.67x Medicare
The contracted insurance negotiated median rate for a Blood test, thyroid (TSH) at Mercy Hospital Pittsburg, Inc is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $138. Compared to the federal Medicare reimbursement reference rate of $16.8, this hospital’s rate is 1.67x the Medicare baseline. Located in 1 Mt Carmel Way, Pittsburg, KS.
Cash / Self-Pay
$138

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$16.8

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $16.8 (100%)
Cash / Self-Pay: $138 (821%)
Insurance Median: $28 (167%)
Cash: $138 (821% of Medicare)
Ins. Median: $28 (167% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $16.8 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 $15 - $144 89%
Medicaid / KanCare $15 - $29 89%
Humana $15 - $16 89%
Aetna $15 - $181 89%
Pace Of The Ozarks Contracted [320518] $16 95%
Dept Of Veteran Affairs Contracted [320106] $16 95%
Halo Hcr Inc Hospice [20432] $16 95%
Medica Contracted [320239] $16 95%
Medicare (plans) $16 95%
Kindful Hospice Contracted [320434] $16 95%
Cross Timbers Hospice [20098] $16 95%
Kindful Hospice [20434] $16 95%
Elara Caring Aspire Hospice [20433] $16 95%
Blue Cross Blue Shield $16 - $53 95%
Tricare $16 95%
Halo Hcr Inc Hospice Contracted [320432] $16 95%
Mercy Hospice Okc [20252] $16 95%
American Health Advantage Of Ks Mcr Contracted [320508] $17 101%
Health Choice Contracted [320166] $23 137%
Ambetter / Centene $29 173%
Home State Health Plan Contracted [320187] $29 173%
Providrs Care Network Contracted [320484] $32 190%
Cigna $93 - $96 554%
United Medical Resources Contracted [320454] $144 857%
Ebms Contracted [320493] $170 1012%
Mercy Benefit Admin Contracted [320251] $170 1012%
Edison Health Solutions Contracted [320502] $170 1012%
Imagine 360 Contracted [320494] $170 1012%
Yuzu Health Contracted [320521] $170 1012%
Auxiant Contracted [320462] $170 1012%
Aither Health Contracted [320449] $170 1012%
Workers Comp [20426] $170 1012%
Reflect Health Contracted [320492] $170 1012%
American Healthcare Alliance Contracted [320020] $170 1012%
Healthlink Contracted [320179] $170 1012%
First Health Contracted [320128] $181 1077%

Consumer Guidance & Cost Commentary

For the blood test code 84443 (Thyroid TSH) at Mercy Hospital Pittsburg, Inc., the cash price is $138.00, which is significantly lower than the gross charge of $213.00. While many commercial payers have negotiated rates ranging from $15 to $181, the cash price often represents a better option for patients with high-deductible plans or those without insurance, as it bypasses the administrative overhead and markup associated with insurance billing. To maximize savings, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by eliminating claim processing fees and bad debt risks.

The facility's cash rate of $138.00 is notably higher than the median negotiated rate of $28.00 and the median paid amount of $17.00 reported for this service, though it remains below the gross charge. When comparing to the broader market, the facility's pricing structure is consistent with the state of Kansas, where similar services often see wide variations between commercial contracts and cash prices. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, it is crucial to verify the specific allowed amount with the insurer before receiving care to avoid unexpected costs. Always request a detailed, itemized bill to ensure all charges are accurate and to identify any unbundled codes or services not rendered.

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