Blood test, thyroid (TSH)
Facility: Phillips County Hospital
Billing Code: 84443 (CPT)
- CPT Billing Code: 84443
- Insurance Median: $59
- Cash Discount Price: $55
- vs. Medicare Baseline: 3.51x 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 351% of the Medicare baseline (a markup of 251%). 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 | $44 - $53 | 262% |
| UnitedHealthcare | $52 - $65 | 310% |
| Health Partners-All Plans | $65 | 387% |
| Medicaid / KanCare | $65 | 387% |
Consumer Guidance & Cost Commentary
For the CPT code 84443, representing a thyroid blood test (TSH), Phillips County Hospital in Phillipsburg, KS, lists a gross charge of $65.00. While the facility's cash median price is $55.00, which is lower than the gross charge, it is important to note that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. For instance, UnitedHealthcare's negotiated rate range is $52.00 to $65.00, and Blue Cross Blue Shield's range is $44.00 to $53.00. Patients with high-deductible plans may find paying the cash price of $55.00 more cost-effective than using insurance, as the insurer's allowed amount could be higher, potentially resulting in a balance bill or out-of-pocket costs exceeding the cash rate. Additionally, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
When evaluating the cost of this service, it is crucial to compare rates against the Medicare benchmark rather than the hospital's inflated gross charge. The Medicare amount for this procedure is $16.80, which serves as the objective baseline for fair pricing. The facility's cash price of $55.00 represents a significant markup over the Medicare rate, reflecting the costs of physician work, practice expenses, and malpractice insurance. While the data does not provide specific state or county average comparisons for this exact code, understanding that commercial rates typically average 200% to 300% of the Medicare rate helps contextualize the $65.