CMS Price Transparency Data

Blood test, thyroid (TSH)

Facility: Hiawatha Community Hospital

Billing Code: 84443 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84443
  • Insurance Median: $132
  • Cash Discount Price: $170
  • vs. Medicare Baseline: 7.86x Medicare
The contracted insurance negotiated median rate for a Blood test, thyroid (TSH) at Hiawatha Community Hospital is $132. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $170. Compared to the federal Medicare reimbursement reference rate of $16.8, this hospital’s rate is 7.86x the Medicare baseline. Located in 300 Utah Street, Hiawatha, KS.
Cash / Self-Pay
$170

Average discount available for prompt cash payment at this facility.

Insurance Median
$132

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: $170 (1012%)
Insurance Median: $132 (786%)
Cash: $170 (1012% of Medicare)
Ins. Median: $132 (786% 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 786% of the Medicare baseline (a markup of 686%). 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
Blue Cross Blue Shield $42 - $44 250%
UnitedHealthcare $63 - $146 375%
Aetna $63 - $137 375%
Humana $64 381%
Ambetter / Centene $75 446%
Centrus Health Direct - All Plans $128 762%
Oscar - All Plans $128 762%
Preferred Hlth - All Plans $153 911%
Cigna $162 964%
Wppa Providrs Care - All Plans $162 964%
Multiplan - All Plans $165 982%
Midlands Choice - All Plans $165 982%
Healthy Blue Mcaid - All Plans $170 1012%

Consumer Guidance & Cost Commentary

For the blood test, thyroid (TSH) procedure at Hiawatha Community Hospital, the cash price is $170.00, which matches the facility's gross charge and the median cash rate. While the hospital's negotiated rates range from $42 to $170 depending on the insurance plan, the cash price is notably higher than the median negotiated rate of $132.00 and the median paid amount of $128.00. This suggests that for patients with high-deductible plans or those without insurance, paying cash directly may be more cost-effective than relying on insurance, as the insurer's allowed amount often exceeds the cash price. However, patients should verify if their specific plan has a lower negotiated rate before scheduling, as some carriers like Blue Cross Blue Shield have a low end of $42, while others like Cigna or Multiplan charge the full $165.

It is important to note that the facility's cash rate of $170.00 is 7.9% higher than the Medicare benchmark of $16.80, indicating a markup relative to the federal cost baseline. Since Medicare rates represent a scientifically validated cost standard, comparing your commercial rate to this figure rather than the hospital's inflated chargemaster list can reveal the true cost of care. Additionally, because the facility is a Critical Access Hospital in Hiawatha, KS, you should explicitly ask about "self-pay" or "prompt-pay" discounts before check-in, as these upfront payment incentives can reduce the final bill by 20% to 50%. If you receive a bill after insurance submission, ensure it is an itemized statement to avoid balance billing for

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 Utah Street, Hiawatha, KS 66434
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals