CMS Price Transparency Data

Blood test, magnesium

Facility: Nemaha Valley Community Hospital

Billing Code: 83735 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83735
  • Insurance Median: $31
  • Cash Discount Price: $47
  • vs. Medicare Baseline: 4.63x Medicare
The contracted insurance negotiated median rate for a Blood test, magnesium at Nemaha Valley Community Hospital is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $6.7, this hospital’s rate is 4.63x the Medicare baseline. Located in 1600 Community Dr, Seneca, KS.
Cash / Self-Pay
$47

Average discount available for prompt cash payment at this facility.

Insurance Median
$31

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: $47 (701%)
Insurance Median: $31 (463%)
Cash: $47 (701% of Medicare)
Ins. Median: $31 (463% 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 463% of the Medicare baseline (a markup of 363%). 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
Va Ccn - All Plans $2 - $5 30%
Aetna $15 - $60 224%
Humana $15 - $31 224%
Celtic Comm Exch - All Plans $16 - $34 239%
Partners Direct Health - All Plans $18 - $36 269%
Multiplan - All Plans $31 - $63 463%
Midlands Choice - All Plans $32 - $66 478%
Health Partners - All Plans $32 - $66 478%

Consumer Guidance & Cost Commentary

For the blood test, magnesium procedure (CPT 83735) at Nemaha Valley Community Hospital in Seneca, KS, the facility's cash median price is $47.00, which is slightly lower than the state average of $47.00. While the hospital's negotiated rates with major payers like Aetna and Humana range from $15 to $66, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying the cash rate directly. To maximize savings, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing costly insurance claims processing.

When using insurance, the median allowed amount is $33.00, which is lower than the gross charge of $52.00 but still higher than the cash price. It is important to note that Medicare sets a benchmark of $6.70 for this service, indicating that commercial negotiated rates are significantly higher than the federal baseline. Patients should be aware that balance billing is generally prohibited for in-network services under the No Surprises Act, but they must verify their specific plan details to ensure they are not facing unexpected out-of-network charges. Always review the itemized bill for accuracy, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Community Dr, Seneca, KS 66538
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals