Blood test, thyroid (TSH)
Facility: Cloud County Health Center
Billing Code: 84443 (CPT)
- CPT Billing Code: 84443
- Insurance Median: $96
- Cash Discount Price: $74
- vs. Medicare Baseline: 5.71x 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 $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 571% of the Medicare baseline (a markup of 471%). 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 |
|---|---|---|
| Aetna | $52 - $143 | 310% |
| Mpi-All Plans | $55 - $146 | 327% |
| Health Partners - All Plans | $55 - $146 | 327% |
| Pponext-All Plans | $55 - $146 | 327% |
Consumer Guidance & Cost Commentary
For the CPT code 84443, representing a blood test for thyroid function (TSH), Cloud County Health Center in Concordia, KS, lists a gross charge of $105.00. This facility is a Critical Access Hospital with a voluntary non-profit ownership structure. When comparing pricing benchmarks, the facility's cash median rate of $74.00 is notably lower than its negotiated rates, which range from $52 to $146 across four major payers including Aetna, Mpi-All Plans, Health Partners, and Pponext. It is important to note that while commercial negotiated rates often exceed cash prices due to administrative overhead and contract dynamics, patients with high-deductible plans may find the cash price more advantageous if their insurance allowed amount is higher than $74.00. Additionally, patients should inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill by bypassing the costly insurance claims processing cycle.
The facility's Medicare benchmark amount for this service is $16.80, which serves as the objective baseline for evaluating pricing markup under federal guidelines. Commercial rates, such as the median negotiated rate of $96.00, often average between 200% and 300% of the Medicare rate, whereas fair pricing is typically defined as 120% to 150% of this benchmark. While the provided data does not include specific state or county average comparisons for this code, the significant difference between the Medicare rate and the facility's cash price highlights the potential for substantial savings when paying directly. Patients should be aware that balance billing is generally