Blood test, calcium
Facility: Nemaha Valley Community Hospital
Billing Code: 82310 (CPT)
- CPT Billing Code: 82310
- Insurance Median: $23
- Cash Discount Price: $40
- vs. Medicare Baseline: 4.46x 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 $5.16 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 446% of the Medicare baseline (a markup of 346%). 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 |
|---|---|---|
| Va Ccn - All Plans | $2 | 39% |
| Humana | $19 | 368% |
| Aetna | $20 - $37 | 388% |
| Celtic Comm Exch - All Plans | $21 | 407% |
| Partners Direct Health - All Plans | $23 | 446% |
| Multiplan - All Plans | $40 | 775% |
| Health Partners - All Plans | $42 | 814% |
| Midlands Choice - All Plans | $42 | 814% |
Consumer Guidance & Cost Commentary
For the blood test, calcium procedure (CPT 82310) at Nemaha Valley Community Hospital in Seneca, KS, the facility's cash price is $40.00, which is slightly lower than the state average of $44.00. While the hospital's negotiated rates with major payers like Aetna and Humana range from $19 to $42, these amounts are generally higher than the cash price due to administrative costs and contract structures. It is important to note that for patients with high-deductible plans, paying the cash price of $40.00 upfront can sometimes be more cost-effective than relying on insurance, as the negotiated rates often exceed the cash rate. Additionally, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
When evaluating this charge, it is crucial to compare the facility's pricing against the Medicare benchmark rather than the hospital's gross chargemaster list. The Medicare amount for this service is $5.16, and the facility's cash price of $40.00 represents a significant markup relative to this federal baseline, which serves as the objective standard for healthcare costs. While commercial negotiated rates typically average between 200% and 300% of the Medicare rate, fair pricing is generally defined as 120% to 150% of this benchmark. Patients should request an itemized bill to ensure no errors exist, as over 80% of hospital bills contain mistakes such as double-billing or unbundled codes. Finally, if you have insurance, check your deductible status before scheduling, as you