CMS Price Transparency Data

Blood test, magnesium

Facility: Mercy Specialty Hospital Southeast Kansas

Billing Code: 83735 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83735
  • Insurance Median: $15
  • Cash Discount Price: $103
  • vs. Medicare Baseline: 2.24x Medicare
The contracted insurance negotiated median rate for a Blood test, magnesium at Mercy Specialty Hospital Southeast Kansas is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $103. Compared to the federal Medicare reimbursement reference rate of $6.7, this hospital’s rate is 2.24x the Medicare baseline. Located in 1619 K 66, Galena, KS.
Cash / Self-Pay
$103

Average discount available for prompt cash payment at this facility.

Insurance Median
$15

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$6.7

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $6.7 (100%)
Cash / Self-Pay: $103 (1537%)
Insurance Median: $15 (224%)
Cash: $103 (1537% of Medicare)
Ins. Median: $15 (224% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $6.7 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 224% of the Medicare baseline (a markup of 124%). 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.

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
United Medical Resources Contracted [320454] $5 - $18 75%
UnitedHealthcare $5 - $147 75%
Medica Contracted [320239] $6 90%
Humana $6 - $7 90%
Blue Cross Blue Shield $6 - $18 90%
Medicaid / KanCare $6 - $10 90%
First Health Contracted [320128] $6 90%
Aetna $6 - $7 90%
Cigna $7 - $39 104%
Medical Associates Health Contracted [320444] $7 104%
Cross Timbers Hospice [20098] $7 104%
Kindful Hospice Contracted [320434] $7 104%
Cherokee Nation Health Serv Contracted [320066] $7 104%
Pace Of The Ozarks Contracted [320518] $7 104%
Provider Partners Health Plans Contracted [320450] $7 104%
Tricare $7 104%
Kindful Hospice [20434] $7 104%
Dept Of Veteran Affairs Contracted [320106] $7 104%
Medicare (plans) $7 104%
Halo Hcr Inc Hospice Contracted [320432] $7 104%
Qual Choice Contracted [320325] $7 104%
Globalhealth Contracted [320145] $7 104%
Elara Caring Aspire Hospice [20433] $7 104%
Halo Hcr Inc Hospice [20432] $7 104%
Mercy Hospice Okc [20252] $7 104%
Mercy Mgd Behavioral Health Contracted [320259] $7 104%
Centivo Contracted [320505] $11 164%
Providrs Care Network Contracted [320484] $13 194%
Health Systems Inc Contracted [320174] $18 269%
Healthscope Contracted [320182] $18 - $119 269%
Benefit Management Contracted [320052] $18 269%
Point C Contracted [320238] $18 - $119 269%
Insurance System Inc Contracted [320465] $18 269%
Show-Me Health Administrators Contracted [320483] $41 612%
Mercy Benefit Admin Contracted [320251] $41 - $111 612%
Yuzu Health Contracted [320521] $111 1657%
Imagine 360 Contracted [320494] $111 1657%
Ebms Contracted [320493] $111 1657%
Aither Health Contracted [320449] $111 1657%
Auxiant Contracted [320462] $111 - $119 1657%
Edison Health Solutions Contracted [320502] $111 1657%
Reflect Health Contracted [320492] $111 1657%
American Healthcare Alliance Contracted [320020] $111 1657%
Preferred Health Plan Contracted [320522] $119 1776%
Healthlink Contracted [320179] $119 1776%
Federal Medical Center Contracted [320127] $119 1776%
Compcare Of The Ozarks Contracted [320437] $126 1881%
Workers Comp [20426] $127 1896%
Private Health Care Systems Contracted [320320] $147 2194%
Multiplan Contracted [320270] $151 2254%
Multiplan [20270] $151 2254%

Consumer Guidance & Cost Commentary

For the blood test, magnesium procedure (CPT 83735), Mercy Specialty Hospital Southeast Kansas lists a gross charge of $159.00, with a cash median price of $103.00 and a negotiated median paid rate of $17.00. This cash price is notably lower than the facility's gross charge, and while the data does not provide specific county or state average comparisons for this exact procedure, patients should be aware that cash-pay options can sometimes be more cost-effective than insurance claims, particularly for those with high-deductible plans where the insurer's negotiated rate might exceed the cash price. It is advisable to contact the hospital directly to confirm "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.

The facility's negotiated rates vary significantly across payers, ranging from a low of $5 to a high of $147, with many commercial plans settling around $6 to $18. When comparing these commercial rates to the Medicare benchmark of $6.70, the facility's allowed amounts are substantially higher, reflecting the typical administrative markup inherent in commercial insurance contracts. Patients should be cautious of balance billing if they receive out-of-network care, as federal protections like the No Surprises Act may prevent providers from charging the difference between the contract rate and the allowed amount for emergency services. Furthermore, if a patient receives a summary bill, they should request a full itemized audit to ensure no errors, unbundled codes, or services not rendered are included before making a payment.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1619 K 66, Galena, KS 66739
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals