Blood test, potassium
Facility: Wichita County Health Center
Billing Code: 84132 (CPT)
- CPT Billing Code: 84132
- Insurance Median: $23
- Cash Discount Price: $20
- vs. Medicare Baseline: 4.83x 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 483% of the Medicare baseline (a markup of 383%). 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 |
|---|---|---|
| Medicaid / KanCare | $21 | 441% |
| UnitedHealthcare | $25 | 525% |
Consumer Guidance & Cost Commentary
For this blood test for potassium at Wichita County Health Center, the facility's cash price of $20.00 is lower than the median negotiated rate of $23.00 and the state average of $25.00. While Medicaid and UnitedHealthcare both pay the full negotiated amount of $25.00, patients with high-deductible plans may find paying cash upfront more cost-effective, as the cash rate avoids the administrative overhead and potential balance billing associated with insurance claims. It is important to note that the facility is a Critical Access Hospital in Leoti, Kansas, and while the cash price is competitive, patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling to potentially lower the final amount owed.
The facility's billing practices align with standard industry benchmarks, where commercial rates often exceed the Medicare amount of $4.76 due to negotiated contract structures and administrative costs. Although the cash price is lower than the Medicare rate, this does not indicate an error; rather, it reflects the specific pricing dynamics between the hospital and commercial payers versus the federal government's fixed reimbursement system. To ensure you are not overcharged, always request a detailed, itemized bill before paying, as summary invoices can obscure individual charges. If you receive a balance bill for services not covered by your plan, you may have the right to dispute it under federal protections, but for this specific service, the cash price remains the most transparent and predictable option for self-pay patients.