Blood test, potassium
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 84132 (CPT)
- CPT Billing Code: 84132
- Insurance Median: $45
- Cash Discount Price: $33
- vs. Medicare Baseline: 9.45x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 945% of the Medicare baseline (a markup of 845%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Healthcare Highways [2210] | $45 | 945% |
| Hooray Health [8000] | $45 | 945% |
| Blue Cross Blue Shield | $45 | 945% |
| Web Tpa [2115] | $45 | 945% |
| Lucent Health [6000] | $45 | 945% |
| Aetna | $45 | 945% |
| Oncology Patient Assistance Programs [2295] | $45 | 945% |
| Black Lung [6055] | $45 | 945% |
| Department Of Corrections [1340] | $55 | 1155% |
| Cigna | $63 | 1324% |
| American Postal Workers Union [1070] | $63 | 1324% |
| Healthpartners [1500] | $63 | 1324% |
| National Association Of Letter Carriers [1695] | $63 | 1324% |
| Humana | $64 | 1345% |
| American Healthcare [1055] | $85 | 1786% |
| Multiplan [1680] | $85 | 1786% |
| Administrative Concepts [1005] | $85 | 1786% |
| First Health [1375] | $85 | 1786% |
| Coventry Healthcare [1320] | $90 | 1891% |
| Ks Disability Determination [6090] | $109 | 2290% |
Consumer Guidance & Cost Commentary
For this blood test for potassium at the University of Kansas Health System - St Francis Campus, the facility's cash price of $33.00 is significantly lower than the median negotiated rate of $45.00 paid by most insurance plans. While the gross charge listed is $109.00, the actual amount most payers contractually agree to pay is $45.00, which is still higher than the cash price. This pricing structure highlights a common scenario where paying out-of-pocket directly can be more cost-effective than using insurance, especially for patients with high-deductible plans who may face higher out-of-pocket costs if their negotiated rate exceeds the cash price. To minimize expenses, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill.
When evaluating this cost, it is important to compare the facility's rates against objective benchmarks rather than the inflated gross charges. The Medicare benchmark for this service is $4.76, which serves as a scientifically validated baseline for the true cost of care, whereas commercial negotiated rates often average 200% to 300% of this amount. Although the data provided does not include specific state or county average comparisons for this code, the significant gap between the Medicare rate and the facility's cash price underscores the importance of understanding the underlying cost structure. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, they should still request an itemized bill to ensure no unbundled codes or services not rendered are included in the final charge.