CMS Price Transparency Data

Blood test, potassium

Facility: Providence Medical Center

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84132
  • Insurance Median: $5
  • Cash Discount Price: $4
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Blood test, potassium at Providence Medical Center is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 1.05x the Medicare baseline. Located in 8929 Parallel Parkway, Kansas City, KS.
Cash / Self-Pay
$4

Average discount available for prompt cash payment at this facility.

Insurance Median
$5

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$4.76

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.76 (100%)
Cash / Self-Pay: $4 (84%)
Insurance Median: $5 (105%)
Cash: $4 (84% of Medicare)
Ins. Median: $5 (105% of 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medicaid / KanCare $4 84%
Celtic $4 - $8 84%
Healthy Blue $4 - $5 84%
UnitedHealthcare $4 - $8 84%
Aetna $5 - $8 105%
Blue Cross Blue Shield $5 - $11 105%
Tricare $5 105%
Cigna $5 105%
Midland Care Connection $5 105%
Kansas Superior Select $5 105%
Medicare (plans) $5 105%
Corizon $6 126%
Naphcare $7 147%
Employer Direct Healthcare $7 147%
Centurion $7 147%
Well Path Prison $7 147%
Comp Alliance - Fka Compresults Worker Compensation $9 189%
Oha Networks $10 210%
Worker Compensation $10 210%

Consumer Guidance & Cost Commentary

For this blood test for potassium at Providence Medical Center in Kansas City, KS, the cash price is $4.00, which is significantly lower than the facility's negotiated rates with major payers like UnitedHealthcare, Aetna, and Blue Cross Blue Shield. While the facility's cash rate is also lower than the state average for this procedure, patients with high-deductible plans should consider paying out-of-pocket directly, as the insurance negotiated rates often exceed the cash price. To secure the lowest possible cost, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass the administrative overhead and higher negotiated ceilings that insurance contracts impose.

It is important to distinguish between the facility's gross charge of $106.00 and the actual amounts billed to patients, as the latter varies by insurance plan. Although the Medicare benchmark for this service is $4.76, commercial negotiated rates frequently range from 200% to 300% of this federal baseline due to administrative costs and contract dynamics. If a patient receives a bill that includes charges from out-of-network ancillary services, such as emergency physicians or specific lab components, they may be subject to balance billing, though the No Surprises Act protects against surprise bills for emergency care and non-emergency services at in-network facilities. Patients should always request a full, itemized CPT-coded bill to verify that no unbundled codes or services not rendered have been included, ensuring they are only paying for the actual care received.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 8929 Parallel Parkway, Kansas City, KS 66112
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals