Blood test, thyroid (TSH)
Facility: Trego County Lemke Memorial Hospital
Billing Code: 84443 (CPT)
- CPT Billing Code: 84443
- Insurance Median: $59
- Cash Discount Price: $59
- 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 |
|---|---|---|
| Va Ccn - All Plans | $12 | 71% |
| Humana | $34 | 202% |
| Tricare | $37 | 220% |
| Aetna | $43 - $62 | 256% |
| Medicaid / KanCare | $43 - $69 | 256% |
| UnitedHealthcare | $43 - $69 | 256% |
| Ambetter / Centene | $47 | 280% |
| Blue Cross Blue Shield | $60 | 357% |
| Health Partners - All Plans | $66 | 393% |
| Healthy Blue Mcaid - All Plans | $69 | 411% |
Consumer Guidance & Cost Commentary
For the thyroid blood test (CPT 84443) at Trego County Lemke Memorial Hospital, the cash price is $59.00, which matches the facility's median negotiated rate and the state average for this service. While the hospital's gross charge is $69.00, patients with high-deductible plans may find paying cash directly more cost-effective than using insurance, as the negotiated rates for major payers like Aetna, UnitedHealthcare, and Medicaid/KanCare range from $43.00 to $69.00, often exceeding the cash price. To maximize savings, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the bill by 20% to 50% by bypassing administrative claim processing fees.
When comparing this facility's pricing to broader benchmarks, the Medicare amount for this procedure is $16.80, which serves as the objective baseline for evaluating fair pricing. The facility's cash rate of $59.00 represents a significant markup over the Medicare rate, consistent with commercial pricing structures that include administrative costs and provider overhead. 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, patients should still verify their specific plan details and deductible status before proceeding. If a discrepancy arises between the expected cash rate and the final bill, requesting a formal, itemized audit is the most effective way to identify errors or unbundled charges that could be corrected.