CMS Price Transparency Data

Blood test, potassium

Facility: Kiowa District Hospital

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84132
  • Insurance Median: $37
  • Cash Discount Price: $31
  • vs. Medicare Baseline: 7.77x Medicare
The contracted insurance negotiated median rate for a Blood test, potassium at Kiowa District Hospital is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $31. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 7.77x the Medicare baseline. Located in 1002 South 4Th Street, Kiowa, KS.
Cash / Self-Pay
$31

Average discount available for prompt cash payment at this facility.

Insurance Median
$37

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$4.76

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.76 (100%)
Cash / Self-Pay: $31 (651%)
Insurance Median: $37 (777%)
Cash: $31 (651% of Medicare)
Ins. Median: $37 (777% of 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 777% of the Medicare baseline (a markup of 677%). 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
Healthchoice-All Plans $7 147%
Blue Cross Blue Shield $10 210%
Tricare $15 315%
UnitedHealthcare $31 - $39 651%
Health Partners Of Ks-All Plans $34 714%
Humana $35 735%
Gbs Insurance - All Plans $37 777%
Triwest-All Plans $37 777%
Multiplan-All Plans $37 777%
Medicare (plans) $37 777%
Aetna $37 777%
Medicaid / KanCare $39 819%
Providers Care (Wppa)-All Plans $58 1218%
Liberty Healthshare-All Plans $63 1324%

Consumer Guidance & Cost Commentary

For this blood test for potassium at Kiowa District Hospital, the cash price is $31.00, which is lower than the facility's negotiated rates of $37.00 paid by most insurance plans. While the facility is a Critical Access Hospital in Kansas, the data does not provide specific county or state average benchmarks for this procedure to compare against. Because commercial insurance contracts often include administrative overheads that can increase the final price by 20% to 40%, patients with high-deductible plans may find paying the cash price of $31.00 directly more cost-effective than relying on insurance, especially if their deductible has not yet been met. It is always advisable to ask the hospital directly about self-pay or prompt-pay discounts before scheduling, as these upfront payment incentives can further reduce the final bill.

The Medicare benchmark for this service is $4.76, which serves as a baseline for evaluating the facility's pricing markup. The facility's cash rate of $31.00 is significantly higher than the Medicare amount, reflecting the complexity of the procedure and local cost factors, but it remains below the negotiated rates charged to most commercial payers. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network emergency care at in-network facilities, it does not automatically apply to all ancillary lab services, so verifying network status is crucial. To ensure accuracy, consumers should request a full itemized bill containing specific CPT codes to review for any unbundled charges or services not rendered, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1002 South 4Th Street, Kiowa, KS 67070
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals