Blood test, thyroid (TSH)
Facility: Rooks County Health Center
Billing Code: 84443 (CPT)
- CPT Billing Code: 84443
- Insurance Median: $69
- Cash Discount Price: $58
- vs. Medicare Baseline: 4.11x 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 $16.8 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 411% of the Medicare baseline (a markup of 311%). 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 | $13 | 77% |
| Celtic Mcr Adv | $36 | 214% |
| Tricare | $36 | 214% |
| Celtic Comm - All Other Plans | $40 | 238% |
| Blue Cross Blue Shield | $44 | 262% |
| Aetna | $69 | 411% |
| UnitedHealthcare | $69 | 411% |
| Preferred Benefits Admin | $69 | 411% |
| Health Partners - All Plans | $73 | 435% |
| Preferred Hlthcare - All Other Plans | $73 | 435% |
| Healthy Blue Mcaid - All Plans | $77 | 458% |
Consumer Guidance & Cost Commentary
For this blood test for thyroid function (TSH) at Rooks County Health Center in Plainville, Kansas, the facility's cash price of $58.00 is lower than the state average of $77.00, though it remains higher than the county average of $54.00. While the facility's negotiated rates with insurance carriers range from $13 to $77, patients with high-deductible plans may find paying the cash price directly more cost-effective if their insurance allowed amount exceeds $58.00. It is important to note that commercial negotiated rates often include administrative overhead and can be significantly higher than the cash price; therefore, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling to potentially reduce the final cost.
The facility's Medicare benchmark of $16.80 serves as a baseline for evaluating pricing, revealing that the cash price is approximately 3.4 times the Medicare rate. This comparison highlights that while commercial rates are higher, they are not necessarily inflated beyond fair market value when compared to the true cost of care. Patients should be aware that balance billing is generally prohibited for emergency services and non-emergency care at in-network facilities under the No Surprises Act, but unexpected charges can still occur if ancillary services like lab tests are billed out-of-network. To avoid errors, consumers should request a full itemized bill before paying, ensuring no unbundled codes or services not rendered are included, and should dispute any discrepancies in writing rather than accepting summary invoices.