Blood test, potassium
Facility: Medicine Lodge Memorial Hospital
Billing Code: 84132 (CPT)
- CPT Billing Code: 84132
- Insurance Median: $19
- Cash Discount Price: $20
- vs. Medicare Baseline: 3.99x 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 399% of the Medicare baseline (a markup of 299%). 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 |
|---|---|---|
| Tricare | $16 | 336% |
| Humana | $18 | 378% |
| UnitedHealthcare | $19 | 399% |
| Hpk-All Plans | $19 | 399% |
| Aetna | $19 - $20 | 399% |
| Medicaid / KanCare | $20 | 420% |
Consumer Guidance & Cost Commentary
For this blood potassium test at Medicine Lodge Memorial Hospital, the facility's cash price of $20.00 aligns exactly with the state average for this procedure. While the hospital's negotiated rates with major payers like Tricare and Humana are also $16.00 to $20.00, patients with high-deductible plans or those without insurance may find the cash price most advantageous. Because commercial insurance contracts often include administrative overhead that inflates the baseline price, paying out-of-pocket can sometimes result in lower total costs compared to the amount an insurer would allow. We recommend contacting the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront fee reductions can further lower the final amount owed.
It is important to understand that while the facility is a Critical Access Hospital in Kansas, the specific CPT code for this blood test does not show a significant variance from the Medicare benchmark of $4.76, which serves as the objective baseline for fair pricing. Although the data indicates a small difference versus Medicare, the primary focus for consumers should be verifying their specific plan's deductible status and allowed amount before scheduling. If you receive a bill that exceeds the negotiated rate or includes unexpected charges, you should request a full itemized statement to review every line item for errors or unbundled codes, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit dispute.