Blood test, calcium
Facility: Holton Community Hospital
Billing Code: 82310 (CPT)
- CPT Billing Code: 82310
- Insurance Median: $38
- Cash Discount Price: $34
- vs. Medicare Baseline: 7.36x 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 736% of the Medicare baseline (a markup of 636%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $11 | 213% |
| Aetna | $24 - $46 | 465% |
| UnitedHealthcare | $24 - $46 | 465% |
| Humana | $24 | 465% |
| Kansas Superior Select - All Plans | $25 | 484% |
| Preferred Health Professionals | $38 | 736% |
| Preferred Health Freedom | $38 | 736% |
| Preferred Health Fn Select - All Other Plans | $38 | 736% |
| Wppa Providers - All Plans | $43 | 833% |
| Medicaid / KanCare | $46 | 891% |
Consumer Guidance & Cost Commentary
For Holton Community Hospital's blood calcium test (CPT 82310), the cash price of $34.00 is notably lower than the facility's negotiated rates, which range from $11.00 to $46.00 depending on the insurance carrier. While Medicaid and KanCare plans pay the lowest negotiated amount of $46.00, several commercial payers like Blue Cross Blue Shield and Humana negotiate rates as low as $11.00 to $24.00. It is important to note that cash-pay rates can sometimes be cheaper for patients with high-deductible plans if the insurance negotiated rate exceeds the cash price, so patients should verify their specific plan's allowed amount before scheduling. Additionally, patients should ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill.
When evaluating the cost against federal standards, the Medicare benchmark rate for this service is $5.16. The facility's cash price of $34.00 represents a significant markup relative to this federal baseline, illustrating how commercial rates often differ substantially from the government's cost-based calculation. While the facility is a Critical Access Hospital in Kansas with a voluntary non-profit ownership structure, the wide variation in negotiated rates across different payers highlights the importance of checking your specific plan's coverage. To ensure you are not overpaying, we recommend requesting a full itemized bill to review every code and service, as over 80% of hospital bills contain errors that can be corrected through a formal audit.