Blood test, potassium
Facility: Nmc Health
Billing Code: 84132 (CPT)
- CPT Billing Code: 84132
- Insurance Median: $31
- Cash Discount Price: $33
- vs. Medicare Baseline: 6.51x 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 651% of the Medicare baseline (a markup of 551%). 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 | $10 | 210% |
| Aetna | $14 - $39 | 294% |
| Wppa | $26 | 546% |
| Occunet | $28 | 588% |
| Samaritan Ministries International | $31 | 651% |
| Medincrease Health Plan | $31 | 651% |
| Prime Health Services | $35 | 735% |
| UnitedHealthcare | $42 | 882% |
| Cigna | $45 | 945% |
Consumer Guidance & Cost Commentary
For this blood test for potassium at Nmc Health in Newton, KS, the cash price of $33.00 is notably lower than the facility's negotiated rates with major insurers, which range from $10 to $45 depending on the plan. While the cash price is also lower than the state average for this service, it is important to note that commercial insurance contracts often result in higher out-of-pocket costs for patients due to administrative fees and network tiers. If you have a high-deductible plan, paying the cash price upfront may be more cost-effective than relying on insurance, as the negotiated rate could exceed the cash amount. Patients should verify their specific plan's deductible status and ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill.
The facility's cash rate of $33.00 is also lower than the Medicare benchmark of $4.76, indicating a significant markup relative to the federal government's cost-based reimbursement. This highlights the importance of comparing rates against Medicare rather than the hospital's full chargemaster list, which is often inflated to make discounts appear larger. If you receive an itemized bill that includes unexpected charges or services not rendered, you should request a formal itemized audit to identify errors such as code unbundling or duplicate billing. Remember that the No Surprises Act protects you from balance billing for out-of-network services at in-network facilities, so if you encounter a surprise bill, you should dispute it with your insurer rather than paying immediately.