Blood test, potassium
Facility: Mcpherson Hospital
Billing Code: 84132 (CPT)
- CPT Billing Code: 84132
- Insurance Median: $22
- Cash Discount Price: $20
- vs. Medicare Baseline: 4.62x 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 462% of the Medicare baseline (a markup of 362%). 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 |
|---|---|---|
| Tricare | $4 | 84% |
| Va Ccn - All Plans | $5 | 105% |
| Humana | $5 | 105% |
| UnitedHealthcare | $5 - $89 | 105% |
| Wellcare Mcr Adv - All Plans | $5 | 105% |
| Blue Cross Blue Shield | $5 | 105% |
| Healthy Blue Mcr Adv | $5 | 105% |
| Ambetter / Centene | $5 | 105% |
| Wppa - All Plans | $15 - $62 | 315% |
| Central Plains - All Plans | $16 - $67 | 336% |
| Medical Associates - All Plans | $16 - $67 | 336% |
| Aetna | $18 - $89 | 378% |
| Christian Health Aid - All Plans | $18 - $71 | 378% |
| Multiplan - All Plans | $20 - $80 | 420% |
| Health Partners - All Plans | $21 - $85 | 441% |
| First Health - All Plans | $21 - $85 | 441% |
| Cigna | $21 - $85 | 441% |
| Health Blue Mcaid - All Other Plans | $22 - $91 | 462% |
| Medicaid / KanCare | $22 - $89 | 462% |
Consumer Guidance & Cost Commentary
For this blood test for potassium at McPherson Hospital, the facility's cash price of $20.00 is lower than the state average of $21.00 and the median negotiated rate of $22.00. While many insurance plans, including UnitedHealthcare and Aetna, negotiate rates ranging from $18 to $91, patients with high-deductible plans may find paying the cash price upfront more cost-effective, as the cash rate is already below the typical negotiated ceiling. To maximize savings, patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as hospitals often offer a fee reduction of 20% to 50% for upfront payment that bypasses the administrative costs of claims processing.
The facility's pricing is benchmarked against the federal Medicare rate of $4.76, which serves as a scientifically validated baseline for the true cost of care. Although the hospital's gross charge is $27.00, the negotiated rates for in-network payers are generally higher than the cash price due to the administrative load and contract structures required by insurance companies. Patients should avoid accepting summary bills and instead request a full itemized audit to ensure no errors or unbundled codes are included, as over 80% of hospital bills contain discrepancies. By comparing the facility's rates directly to the state average and understanding that commercial rates often exceed Medicare benchmarks, consumers can make informed decisions about whether to use insurance or pay out-of-pocket.