CMS Price Transparency Data

Blood test, thyroid (TSH)

Facility: Ellsworth County Medical Center

Billing Code: 84443 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84443
  • Insurance Median: $49
  • Cash Discount Price: $55
  • vs. Medicare Baseline: 2.92x Medicare
The contracted insurance negotiated median rate for a Blood test, thyroid (TSH) at Ellsworth County Medical Center is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $55. Compared to the federal Medicare reimbursement reference rate of $16.8, this hospital’s rate is 2.92x the Medicare baseline. Located in 1604 Aylward Avenue, Ellsworth, KS.
Cash / Self-Pay
$55

Average discount available for prompt cash payment at this facility.

Insurance Median
$49

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: $55 (327%)
Insurance Median: $49 (292%)
Cash: $55 (327% of Medicare)
Ins. Median: $49 (292% 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 292% of the Medicare baseline (a markup of 192%). 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
Humana $26 - $52 155%
Healthy Blue Mcr Adv $26 155%
Va Ccn-All Plans $26 155%
Triwest -All Plans $26 155%
UnitedHealthcare $35 - $54 208%
Blue Cross Blue Shield $41 - $44 244%
First Health - All Plans $49 292%
Aetna $49 292%
Cigna $52 310%
Healthy Blue Mcaid- All Other Plans $54 321%
Coventry Mcaid-All Plans $54 321%
Medicaid / KanCare $54 321%
Providers Care-Wppa-All Plans $82 488%

Consumer Guidance & Cost Commentary

For the thyroid blood test (CPT 84443) at Ellsworth County Medical Center in Ellsworth, KS, the cash price is $55.00, which matches the facility's negotiated rate of $49.00 and the median paid amount of $29.00. This cash price is significantly lower than the gross chargemaster of $55.00 and the Medicare benchmark of $16.80, indicating a substantial markup relative to federal reimbursement standards. While the facility is a Critical Access Hospital with a Proprietary ownership structure, patients should be aware that commercial insurance plans negotiate rates that often exceed cash prices due to administrative costs and contract dynamics. For instance, UnitedHealthcare's negotiated range spans $35 to $54, and Blue Cross Blue Shield's range is $41 to $44, both of which are higher than the cash-pay option.

Patients with high-deductible plans may find paying the full cash price of $55.00 more cost-effective than relying on insurance, as the negotiated rates for many payers exceed this amount. It is crucial to verify your specific plan's deductible status and allowed amount before scheduling, as paying the cash price upfront can bypass the complex claims processing that often inflates final bills. If you receive a bill from an out-of-network provider or encounter unexpected charges, you have the right to request an itemized audit to identify errors such as unbundled codes or services not rendered, and you may be protected under the No Surprises Act from balance billing for certain services. Always ask the billing department about self-pay or prompt-pay discounts before check-in to ensure you are receiving the most favorable rate

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1604 Aylward Avenue, Ellsworth, KS 67439
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals