Blood test, thyroid (TSH)
Facility: Decatur Health
Billing Code: 84443 (CPT)
- CPT Billing Code: 84443
- Insurance Median: $62
- Cash Discount Price: $73
- vs. Medicare Baseline: 3.69x 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 369% of the Medicare baseline (a markup of 269%). 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 | $49 | 292% |
| Humana | $50 | 298% |
| UnitedHealthcare | $50 - $62 | 298% |
| Blue Cross Blue Shield | $57 | 339% |
| Aetna | $73 - $82 | 435% |
| Midlands Choice- All Plans | $73 | 435% |
| Medicaid / KanCare | $82 | 488% |
Consumer Guidance & Cost Commentary
For this thyroid blood test (CPT 84443) at Decatur Health in Oberlin, KS, the facility's cash price of $73.00 is notably higher than the state average of $60.00, though it aligns closely with the county average. While commercial insurance plans like UnitedHealthcare and Aetna negotiate rates ranging from $50 to $82, these amounts often exceed the cash price, making self-pay a potentially more economical option for patients with high-deductible plans. Because the facility is a Critical Access Hospital, patients should proactively ask about "self-pay" or "prompt-pay" discounts before scheduling, as paying in full upfront can sometimes bypass the administrative overhead that inflates insurance negotiated rates.
It is important to understand that commercial insurance rates are not always the lowest available; in this case, the cash rate is competitive with or lower than many negotiated amounts. If you choose to use insurance, be aware that the facility's gross charge is $82.00, but the actual amount paid by insurers varies significantly by plan, with some paying as little as $49.00. To ensure you are not overcharged, always request an itemized bill that lists specific CPT codes rather than accepting a summary invoice, and verify your deductible status before proceeding, as you may be responsible for the full negotiated amount if your plan has not yet covered this service.