Blood test, potassium
Facility: Hiawatha Community Hospital
Billing Code: 84132 (CPT)
- CPT Billing Code: 84132
- Insurance Median: $37
- Cash Discount Price: $47
- vs. Medicare Baseline: 7.77x 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 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $9 - $10 | 189% |
| UnitedHealthcare | $17 - $40 | 357% |
| Aetna | $17 - $38 | 357% |
| Humana | $18 | 378% |
| Ambetter / Centene | $21 | 441% |
| Centrus Health Direct - All Plans | $35 | 735% |
| Oscar - All Plans | $35 | 735% |
| Preferred Hlth - All Plans | $42 | 882% |
| Wppa Providrs Care - All Plans | $45 | 945% |
| Cigna | $45 | 945% |
| Multiplan - All Plans | $46 | 966% |
| Midlands Choice - All Plans | $46 | 966% |
| Healthy Blue Mcaid - All Plans | $47 | 987% |
Consumer Guidance & Cost Commentary
For the blood test, potassium procedure (CPT 84132) at Hiawatha Community Hospital in Hiawatha, KS, the cash price is $47.00, which matches the facility's gross charge and the state average. While the hospital's negotiated rates with major payers like Blue Cross Blue Shield and UnitedHealthcare range from $9 to $40, these amounts are often higher than the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find paying the $47.00 cash price more cost-effective than using insurance, as the negotiated allowed amounts can exceed the cash rate. It is important to note that while the facility is a Critical Access Hospital with a voluntary non-profit ownership, commercial rates can sometimes be inflated; therefore, patients should always verify their specific plan's allowed amount before scheduling to ensure they are not paying more than necessary.
To avoid unexpected costs, patients should request a prompt-pay discount if they choose to pay out-of-network or self-pay, as hospitals often offer reductions for upfront payment to bypass costly claims processing. Additionally, if a patient receives a bill from an out-of-network provider at this facility, they should be aware of the No Surprises Act, which prohibits balance billing for emergency care and non-emergency services at in-network facilities. If a surprise bill does occur, patients should dispute it in writing with the insurer rather than paying immediately, and they should demand a full itemized audit of the statement to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors that can be corrected through formal written disputes.