Blood test, calcium
Facility: Decatur Health
Billing Code: 82310 (CPT)
- CPT Billing Code: 82310
- Insurance Median: $18
- Cash Discount Price: $21
- vs. Medicare Baseline: 3.49x 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 $5.16 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 349% of the Medicare baseline (a markup of 249%). 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 | $14 | 271% |
| Wppa/Providrs Care- All Plans | $14 | 271% |
| UnitedHealthcare | $14 - $18 | 271% |
| Humana | $15 | 291% |
| Midlands Choice- All Plans | $21 | 407% |
| Aetna | $21 - $24 | 407% |
| Medicaid / KanCare | $24 | 465% |
Consumer Guidance & Cost Commentary
For this blood calcium test at Decatur Health in Oberlin, Kansas, the facility's cash price of $21.00 is slightly higher than the state average of $17.00 but aligns closely with the local county median. While commercial insurance plans like UnitedHealthcare and Aetna have negotiated rates ranging from $14 to $24, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan details before scheduling. Additionally, asking the hospital about "self-pay" or "prompt-pay" discounts before check-in can sometimes result in a lower final bill than the listed cash rate.
The facility's negotiated rates vary significantly by payer, with Blue Cross Blue Shield and Humana paying the lowest amounts at $14, while Aetna and UnitedHealthcare pay up to $24. These commercial rates are notably higher than the Medicare benchmark of $5.16, reflecting the administrative costs and contract structures inherent in private insurance. Because over 80% of hospital bills contain errors, patients should request a full itemized CPT-coded statement rather than accepting a summary bill, which can hide unbundled charges or services not rendered. If you receive a bill that seems unusually high, you have the right to dispute it in writing with the billing supervisor to ensure accuracy and avoid unexpected costs.