Blood test, potassium
Facility: Nemaha Valley Community Hospital
Billing Code: 84132 (CPT)
- CPT Billing Code: 84132
- Insurance Median: $17
- Cash Discount Price: $29
- vs. Medicare Baseline: 3.57x 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 357% of the Medicare baseline (a markup of 257%). 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 | 42% |
| Humana | $14 | 294% |
| Aetna | $14 - $27 | 294% |
| Celtic Comm Exch - All Plans | $15 | 315% |
| Partners Direct Health - All Plans | $17 | 357% |
| Multiplan - All Plans | $29 | 609% |
| Midlands Choice - All Plans | $30 | 630% |
| Health Partners - All Plans | $30 | 630% |
Consumer Guidance & Cost Commentary
For the blood test, potassium procedure (CPT 84132) at Nemaha Valley Community Hospital in Seneca, KS, the facility's cash median price is $29.00, which is 3.6 times the Medicare benchmark of $4.76. While the hospital offers a negotiated rate of $17.00 for in-network patients, this amount is still significantly higher than the cash price. Because commercial insurance plans often include administrative overhead and claim processing costs, paying cash upfront can sometimes result in lower out-of-pocket expenses for patients with high-deductible plans. To maximize savings, patients should verify if the hospital offers a prompt-pay discount, which typically reduces the bill by 20% to 50% for upfront payment, effectively bypassing the administrative fees associated with insurance billing cycles.
The facility's negotiated rates vary across eight payers, ranging from a low of $2.00 for Va Ccn - All Plans to a high of $30.00 for Midland Choice and Health Partners. Although the data does not provide specific county or state average comparisons for this procedure, the wide variance in negotiated rates highlights the importance of checking your specific plan's allowed amount before scheduling. 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 surprise costs, consumers should request an itemized bill before payment and dispute any charges that do not align with the negotiated rates or Medicare benchmarks.