Blood test, potassium
Facility: Graham County Hospital
Billing Code: 84132 (CPT)
- CPT Billing Code: 84132
- Insurance Median: $15
- Cash Discount Price: $26
- vs. Medicare Baseline: 3.15x 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 315% of the Medicare baseline (a markup of 215%). 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 |
|---|---|---|
| UnitedHealthcare | $1 - $25 | 21% |
| Medicaid / KanCare | $7 | 147% |
| Blue Cross Blue Shield | $10 | 210% |
| Medicare (plans) | $19 | 399% |
| Celtic Commercial-All Other Plans | $21 | 441% |
| Wppa (Providers Care)-All Plans | $25 | 525% |
Consumer Guidance & Cost Commentary
For the blood test, potassium procedure (CPT 84132) at Graham County Hospital in Hill City, KS, the cash price is $26.00, which matches the facility's listed gross charge. This rate is notably lower than the state average for this service, as the facility's cash price is significantly below the typical commercial negotiated rates found across Kansas. While commercial payers like UnitedHealthcare and Blue Cross Blue Shield have negotiated rates ranging from $15.00 to $25.00, patients with high-deductible plans may find paying the $26.00 cash price more affordable than facing a large deductible or out-of-pocket maximum. It is important to note that even though this facility is a Critical Access Hospital with government ownership, commercial insurance contracts can sometimes result in higher allowed amounts than the direct cash price, making self-pay a potentially cost-effective option for those without active coverage.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, unexpected charges can still occur if ancillary services are billed separately. To ensure transparency, consumers should request a full itemized bill before paying to verify that no unbundled codes or services not rendered have inflated the total. Additionally, since hospitals often offer prompt-pay discounts for upfront payment, patients should explicitly ask the billing department about self-pay or prompt-pay rates prior to scheduling their visit. Given that the facility's cash rate is already competitive compared to state averages, verifying any potential discounts before check-in can further reduce the final amount owed.