CMS Price Transparency Data

Blood test, potassium

Facility: Sheridan County Hospital

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84132
  • Insurance Median: $24
  • Cash Discount Price: $40
  • vs. Medicare Baseline: 5.04x Medicare
The contracted insurance negotiated median rate for a Blood test, potassium at Sheridan County Hospital is $24. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 5.04x the Medicare baseline. Located in 826 18Th Street, Hoxie, KS.
Cash / Self-Pay
$40

Average discount available for prompt cash payment at this facility.

Insurance Median
$24

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: $40 (840%)
Insurance Median: $24 (504%)
Cash: $40 (840% of Medicare)
Ins. Median: $24 (504% 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 504% of the Medicare baseline (a markup of 404%). 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 $14 294%
Celtic Insurance $24 504%
UnitedHealthcare $38 798%

Consumer Guidance & Cost Commentary

For this blood test for potassium at Sheridan County Hospital in Hoxie, KS, the cash price is $40.00, which matches the facility's median negotiated rate of $24.00 and the state average. While commercial payers like Blue Cross Blue Shield, Celtic Insurance, and UnitedHealthcare have negotiated rates of $14.00, $24.00, and $38.00 respectively, patients with high-deductible plans may find paying the full cash price of $40.00 more cost-effective than relying on insurance, especially if the insurer's allowed amount exceeds the cash rate. Because this facility is a Critical Access Hospital owned by the local government, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can significantly lower the final cost.

The Medicare benchmark for this service is $4.76, indicating that the cash price of $40.00 represents a substantial markup compared to the federal baseline used to evaluate hospital pricing. This disparity highlights the importance of understanding that commercial rates often include administrative overhead and contract dynamics that go beyond the true cost of care. If you receive a bill from an out-of-network provider or encounter unexpected charges, you have the right to request an itemized billing audit to identify errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies. Furthermore, under the No Surprises Act, you are protected from balance billing for emergency care and non-emergency services at in-network facilities, so any surprise bill should be disputed with your insurer rather than paid immediately.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 826 18Th Street, Hoxie, KS 67740
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals