Blood test, potassium
Facility: Susan B Allen Memorial Hospital
Billing Code: 84132 (CPT)
- CPT Billing Code: 84132
- Insurance Median: $554
- Cash Discount Price: $7
- vs. Medicare Baseline: 116.39x 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 11639% of the Medicare baseline (a markup of 11539%). 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 |
|---|---|---|
| UnitedHealthcare | $350 | 7353% |
| Providrs Care | $757 | 15903% |
Consumer Guidance & Cost Commentary
For the blood test for potassium (CPT 84132) at Susan B Allen Memorial Hospital in El Dorado, KS, the facility's cash median price is $7.00, which is significantly lower than the state average of $11.00. While the hospital's negotiated rates with UnitedHealthcare and Providrs Care are $350 and $757 respectively, these figures often exceed the cash price due to administrative overhead and contract structures. Under the principle of negotiated rates, commercial contracts can inflate baseline prices by 20% to 40% to cover claims processing and utilization reviews, meaning patients with high-deductible plans might save money by paying the cash price directly, provided they verify that the insurance allowed amount does not exceed $7.00.
To maximize savings, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling, as these can reduce bills by 20% to 50% by bypassing costly insurance billing cycles. It is important to avoid comparing these rates against the hospital's gross charge of $11.00, as chargemasters are inflated lists that do not reflect actual costs; instead, the Medicare benchmark of $4.76 serves as a scientifically validated baseline for fair pricing. Additionally, patients should ensure they do not inadvertently trigger balance billing by confirming their insurance status, as the No Surprises Act protects against unexpected out-of-network charges at in-network facilities, though verifying the specific status of ancillary lab services is still recommended.