Blood test, potassium
Facility: Holton Community Hospital
Billing Code: 84132 (CPT)
- CPT Billing Code: 84132
- Insurance Median: $21
- Cash Discount Price: $23
- vs. Medicare Baseline: 4.41x 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 441% of the Medicare baseline (a markup of 341%). 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 | $10 | 210% |
| Humana | $12 - $21 | 252% |
| UnitedHealthcare | $12 - $40 | 252% |
| Kansas Superior Select - All Plans | $12 - $21 | 252% |
| Aetna | $12 - $40 | 252% |
| Preferred Health Fn Select - All Other Plans | $19 - $33 | 399% |
| Preferred Health Freedom | $19 - $33 | 399% |
| Preferred Health Professionals | $19 - $33 | 399% |
| Wppa Providers - All Plans | $22 - $38 | 462% |
| Medicaid / KanCare | $23 - $40 | 483% |
Consumer Guidance & Cost Commentary
For this blood test, the facility's cash price of $23.00 is slightly higher than the state average of $21.00, though it remains significantly lower than the gross charge of $31.00. While commercial insurance plans like Blue Cross Blue Shield and Humana negotiate rates ranging from $10 to $40, these negotiated amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying the cash rate directly. To maximize savings, it is advisable to ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid upfront, bypassing the administrative costs associated with insurance claims processing.
When reviewing your final invoice, ensure you receive an itemized bill rather than a summary statement, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Comparing your facility's pricing to the Medicare benchmark of $4.76 reveals that the commercial negotiated rates are substantially higher, highlighting the importance of verifying your plan's allowed amount before scheduling. If you receive a balance bill for services not covered by your in-network contract, you may be entitled to dispute the charge under federal protections, but always confirm your deductible status first to avoid unexpected out-of-pocket expenses.