Blood test, potassium
Facility: Rooks County Health Center
Billing Code: 84132 (CPT)
- CPT Billing Code: 84132
- Insurance Median: $46
- Cash Discount Price: $38
- vs. Medicare Baseline: 9.66x 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 966% of the Medicare baseline (a markup of 866%). 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 |
|---|---|---|
| Veterans Admin - All Plans | $2 | 42% |
| Blue Cross Blue Shield | $10 | 210% |
| Tricare | $24 | 504% |
| Celtic Mcr Adv | $24 | 504% |
| Celtic Comm - All Other Plans | $26 | 546% |
| Preferred Benefits Admin | $46 | 966% |
| Aetna | $46 | 966% |
| UnitedHealthcare | $46 | 966% |
| Health Partners - All Plans | $49 | 1029% |
| Preferred Hlthcare - All Other Plans | $49 | 1029% |
| Healthy Blue Mcaid - All Plans | $51 | 1071% |
Consumer Guidance & Cost Commentary
For the blood test code 84132 at Rooks County Health Center in Plainville, KS, the facility's cash price of $38.00 is notably lower than the state average of $46.00 and the county average of $46.00. While the facility's negotiated rate of $46.00 matches the state and county averages, it is significantly higher than the cash price, illustrating that paying out-of-pocket can sometimes be more cost-effective for patients with high-deductible plans. Because the commercial negotiated rate exceeds the cash price, patients should verify their deductible status before scheduling; if their insurance has not yet met their deductible, they may end up paying the higher negotiated amount rather than the lower cash rate.
To maximize savings, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid in full upfront. This discount bypasses the administrative costs associated with insurance claims processing and provides immediate liquidity to the facility. Additionally, while the facility is a Critical Access Hospital with government ownership, patients should always request a detailed, itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. Comparing the facility's Medicare benchmark rate of $4.76 against the commercial rates reveals a significant markup, reinforcing the importance of understanding the difference between the government's cost baseline and the actual charges billed to commercial payers.