Blood test, calcium
Facility: Nmc Health
Billing Code: 82310 (CPT)
- CPT Billing Code: 82310
- Insurance Median: $47
- Cash Discount Price: $51
- vs. Medicare Baseline: 9.11x 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 $5.16 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 911% of the Medicare baseline (a markup of 811%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $11 | 213% |
| Aetna | $16 - $60 | 310% |
| Wppa | $40 | 775% |
| Occunet | $44 | 853% |
| Medincrease Health Plan | $47 | 911% |
| Samaritan Ministries International | $47 | 911% |
| Prime Health Services | $55 | 1066% |
| UnitedHealthcare | $66 | 1279% |
| Cigna | $69 | 1337% |
Consumer Guidance & Cost Commentary
For the blood test for calcium (CPT code 82310) at Nmc Health in Newton, Kansas, the facility's cash median price is $51.00, which is notably lower than the state average of $73.00. While commercial payers like Aetna and UnitedHealthcare have negotiated rates ranging from $47.00 to $66.00, patients with high-deductible plans may find the cash price more advantageous if their insurance allowed amount exceeds $51.00. It is important to note that the facility's negotiated rate of $47.00 is slightly below the cash price, suggesting that for some insured patients, the out-of-pocket cost could be higher than paying directly. To maximize savings, patients should verify their specific plan's allowed amount before scheduling and inquire about prompt-pay discounts, which can further reduce the final bill.
When evaluating the cost of this service, it is helpful to compare the facility's pricing against the Medicare benchmark, which stands at $5.16 for this procedure. The gross charge of $73.00 represents a significant markup over the Medicare rate, illustrating why comparing against the federal baseline is more accurate than looking at the hospital's full list price. Additionally, the facility's 5-star rating reflects its performance metrics, though this does not directly influence the financial terms of the billing. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, unexpected charges can still occur with ancillary services; therefore, requesting an itemized bill before payment is essential to identify any errors or unbundled codes that may inflate the total cost