CMS Price Transparency Data

Blood test, magnesium

Facility: Holton Community Hospital

Billing Code: 83735 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83735
  • Insurance Median: $53
  • Cash Discount Price: $48
  • vs. Medicare Baseline: 7.91x Medicare
The contracted insurance negotiated median rate for a Blood test, magnesium at Holton Community Hospital is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $48. Compared to the federal Medicare reimbursement reference rate of $6.7, this hospital’s rate is 7.91x the Medicare baseline. Located in 1110 Columbine Drive, Holton, KS.
Cash / Self-Pay
$48

Average discount available for prompt cash payment at this facility.

Insurance Median
$53

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: $48 (716%)
Insurance Median: $53 (791%)
Cash: $48 (716% of Medicare)
Ins. Median: $53 (791% 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 791% of the Medicare baseline (a markup of 691%). 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
Blue Cross Blue Shield $26 388%
Kansas Superior Select - All Plans $34 507%
Aetna $34 - $64 507%
Humana $34 507%
UnitedHealthcare $34 - $64 507%
Preferred Health Fn Select - All Other Plans $53 791%
Preferred Health Freedom $53 791%
Preferred Health Professionals $53 791%
Wppa Providers - All Plans $60 896%
Medicaid / KanCare $64 955%

Consumer Guidance & Cost Commentary

For this blood magnesium test at Holton Community Hospital, the cash price of $48.00 is lower than the facility's negotiated rate of $53.00 and the median negotiated rate across payers. While the facility is a Critical Access Hospital in Kansas, the data provided does not include specific county or state average comparisons for this service. However, patients should note that paying cash directly can sometimes be more cost-effective than using insurance, particularly if their plan has a high deductible or if the insurance negotiated rate exceeds the cash price. It is always advisable to ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the final amount owed.

When using insurance, the allowed amount varies significantly by payer, ranging from a low of $26.00 to a high of $64.00, with a median paid amount of $34.00. This variation highlights that in-network status does not guarantee a single uniform price, as different insurers negotiate different rates. For context, the Medicare benchmark for this procedure is $6.70, which serves as a baseline for evaluating pricing markups; commercial rates are often substantially higher than this federal standard due to administrative costs and contract dynamics. To ensure you are receiving fair pricing, verify your specific plan's allowed amount before the visit and request an itemized bill to review all charges line-by-line, as summary bills may obscure individual costs or unbundled services.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1110 Columbine Drive, Holton, KS 66436
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals