Blood test, potassium
Facility: Decatur Health
Billing Code: 84132 (CPT)
- CPT Billing Code: 84132
- Insurance Median: $13
- Cash Discount Price: $16
- vs. Medicare Baseline: 2.73x 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 $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 273% of the Medicare baseline (a markup of 173%). 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 | $10 | 210% |
| UnitedHealthcare | $11 - $13 | 231% |
| Humana | $11 | 231% |
| Blue Cross Blue Shield | $13 | 273% |
| Aetna | $16 - $17 | 336% |
| Midlands Choice- All Plans | $16 | 336% |
| Medicaid / KanCare | $18 | 378% |
Consumer Guidance & Cost Commentary
For this blood test for potassium at Decatur Health in Oberlin, KS, the cash price of $16.00 is slightly lower than the facility's negotiated rates with major payers like UnitedHealthcare ($11–$13) and Aetna ($16–$17). While the facility's cash rate is close to the state average, it is notably higher than the Medicare benchmark of $4.76, which serves as the objective baseline for fair pricing. Patients with high-deductible plans may find paying the cash price upfront more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. To maximize savings, we recommend asking the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full before or shortly after the service.
The median amount paid by insurers for this service is $12.00, which is lower than the cash price but still significantly above the Medicare rate. 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, unexpected charges can still occur if ancillary services like lab tests are billed separately. If you receive a bill that seems high, request a full itemized audit to verify that all codes are accurate and that no services were unbundled or double-charged. Always compare the facility's negotiated rates against the Medicare benchmark to understand the true cost markup, as commercial rates often include administrative overhead that inflates the price beyond the actual cost of care.