Blood test, potassium
Facility: Phillips County Hospital
Billing Code: 84132 (CPT)
- CPT Billing Code: 84132
- Insurance Median: $28
- Cash Discount Price: $26
- vs. Medicare Baseline: 5.88x 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 588% of the Medicare baseline (a markup of 488%). 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 | $10 - $25 | 210% |
| UnitedHealthcare | $25 - $31 | 525% |
| Health Partners-All Plans | $31 | 651% |
| Medicaid / KanCare | $31 | 651% |
Consumer Guidance & Cost Commentary
For this blood potassium test at Phillips County Hospital in Phillipsburg, KS, the cash price of $26.00 is notably lower than the facility's negotiated rate of $28.00 and the state average of $31.00. While commercial payers like Blue Cross Blue Shield and UnitedHealthcare have negotiated rates ranging from $10 to $31, patients with high-deductible plans may find paying the cash price directly more cost-effective, as the cash rate avoids the administrative overhead and markup often embedded in insurance contracts. It is important to note that the Medicare benchmark for this service is $4.76, which serves as the objective baseline for evaluating pricing; commercial rates typically range from 200% to 300% of this amount, whereas fair pricing is generally considered to be between 120% and 150%.
Patients should proactively contact the hospital before scheduling to inquire about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid upfront, bypassing the costly claims processing cycle. Since the facility is a Critical Access Hospital owned by the local government, verifying the specific discount structure for your situation is essential before relying on insurance coverage. Additionally, if you have received a bill, request a full itemized statement to review every line item for errors or unbundled charges, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit dispute.