CMS Price Transparency Data

Blood test, thyroid (TSH)

Facility: Holton Community Hospital

Billing Code: 84443 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84443
  • Insurance Median: $59
  • Cash Discount Price: $60
  • vs. Medicare Baseline: 3.51x Medicare
The contracted insurance negotiated median rate for a Blood test, thyroid (TSH) at Holton Community Hospital is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $60. Compared to the federal Medicare reimbursement reference rate of $16.8, this hospital’s rate is 3.51x the Medicare baseline. Located in 1110 Columbine Drive, Holton, KS.
Cash / Self-Pay
$60

Average discount available for prompt cash payment at this facility.

Insurance Median
$59

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$16.8

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $16.8 (100%)
Cash / Self-Pay: $60 (357%)
Insurance Median: $59 (351%)
Cash: $60 (357% of Medicare)
Ins. Median: $59 (351% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $16.8 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 351% of the Medicare baseline (a markup of 251%). 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
Aetna $34 - $94 202%
UnitedHealthcare $34 - $94 202%
Kansas Superior Select - All Plans $35 - $51 208%
Humana $35 - $50 208%
Blue Cross Blue Shield $44 262%
Preferred Health Professionals $54 - $78 321%
Preferred Health Fn Select - All Other Plans $54 - $78 321%
Preferred Health Freedom $54 - $78 321%
Wppa Providers - All Plans $62 - $89 369%
Medicaid / KanCare $65 - $94 387%

Consumer Guidance & Cost Commentary

For the blood test for thyroid (TSH) at Holton Community Hospital, the cash price of $60.00 is lower than the facility's negotiated rates with most major payers, which range from $34 to $94. While the facility's cash median of $60.00 is higher than the state average of $54.00, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance negotiated rate exceeds this amount. It is important to note that while the facility is a Critical Access Hospital in Kansas, the specific negotiated rates vary significantly by insurer, with some plans like Kansas Superior Select and Humana offering rates between $35 and $51, while others like Medicaid/KanCare and Preferred Health Professionals range from $54 to $94.

To ensure you receive the most accurate pricing, always ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling your visit, as these can reduce the final bill. Additionally, if you are billed for services from out-of-network providers at this in-network facility, the No Surprises Act protects you from balance billing for emergency care and non-emergency services. If you receive an unexpected bill, do not pay immediately; instead, request a formal itemized audit to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes that can be corrected through a written dispute sent to the billing supervisor.

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