CMS Price Transparency Data

Blood test, thyroid (TSH)

Facility: St Luke Hospital & Living Center

Billing Code: 84443 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84443
  • Insurance Median: $79
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 4.70x Medicare
The contracted insurance negotiated median rate for a Blood test, thyroid (TSH) at St Luke Hospital & Living Center is $79. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $16.8, this hospital’s rate is 4.70x the Medicare baseline. Located in 535 South Freeborn, Marion, KS.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$79

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$16.8

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $16.8 (100%)
Insurance Median: $79 (470%)
Ins. Median: $79 (470% of 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 470% of the Medicare baseline (a markup of 370%). 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $79 470%
Ambetter / Centene $79 470%
Blue Cross Blue Shield $79 470%
Humana $79 470%
Kansas Department Of Health And Environment $79 470%
Bluestem Pace $79 470%
UnitedHealthcare $79 470%

Consumer Guidance & Cost Commentary

For the thyroid blood test (CPT 84443) at St Luke Hospital & Living Center in Marion, KS, the facility's negotiated rate is $79.00, which aligns exactly with the lowest and highest negotiated rates reported across all seven payers, including UnitedHealthcare and Humana. This rate is significantly higher than the Medicare benchmark of $16.80, reflecting a markup of 470% above the federal baseline. While commercial insurance contracts often include administrative overhead that inflates prices, the facility's rate remains consistent across all major insurers, suggesting a standardized pricing structure rather than a tiered network discount.

Patients should be aware that while the negotiated rate is fixed at $79.00 for in-network coverage, the cash price is not listed in the current data. However, for individuals with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price directly could result in lower total costs if the facility offers a self-pay or prompt-pay discount. It is recommended to contact the hospital billing department before scheduling to inquire about "self-pay" rates or prompt-pay incentives, which can reduce the final bill by 20% to 50% by bypassing insurance claims processing fees. Additionally, since this is a Critical Access Hospital, patients should verify that no out-of-network ancillary services are involved to avoid potential balance billing, though the No Surprises Act generally protects against such charges for in-network facility services.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 535 South Freeborn, Marion, KS 66861
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals