Blood test, magnesium
Facility: Decatur Health
Billing Code: 83735 (CPT)
- CPT Billing Code: 83735
- Insurance Median: $37
- Cash Discount Price: $42
- vs. Medicare Baseline: 5.52x 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 $6.7 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 552% of the Medicare baseline (a markup of 452%). 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 |
|---|---|---|
| Wppa/Providrs Care- All Plans | $27 - $29 | 403% |
| UnitedHealthcare | $28 - $37 | 418% |
| Humana | $28 - $30 | 418% |
| Blue Cross Blue Shield | $33 | 493% |
| Midlands Choice- All Plans | $41 - $43 | 612% |
| Aetna | $41 - $48 | 612% |
| Medicaid / KanCare | $46 - $48 | 687% |
Consumer Guidance & Cost Commentary
For this blood test for magnesium at Decatur Health in Oberlin, KS, the facility's cash price of $42.00 is notably higher than the state average of $35.00. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients with high-deductible plans might find that paying cash upfront could be more cost-effective than using insurance, as the facility's negotiated rates with payers like UnitedHealthcare and Aetna range from $28 to $48. It is important to note that commercial insurance rates often include administrative overhead and contract markups, which can make them higher than the cash price even when the service is covered.
Before scheduling, patients should explicitly request a "self-pay" or "prompt-pay" discount, which can reduce the bill by 20% to 50% if paid in full within a short window, bypassing the costly insurance claims process. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to verify your specific plan's deductible status and allowed amounts, as paying the negotiated rate without meeting your deductible could result in higher out-of-pocket costs than the cash price. Finally, if you receive a bill, always demand a full itemized statement rather than accepting a summary invoice, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.