Blood test, potassium
Facility: Clay County Medical Center
Billing Code: 84132 (CPT)
- CPT Billing Code: 84132
- Insurance Median: $31
- Cash Discount Price: $32
- vs. Medicare Baseline: 6.51x 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 $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 651% of the Medicare baseline (a markup of 551%). 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 | $30 | 630% |
| Aetna | $30 | 630% |
| Multiplan- All Plans | $31 | 651% |
| UnitedHealthcare | $31 | 651% |
| Health Partners - All Plans | $31 | 651% |
Consumer Guidance & Cost Commentary
For the blood test for potassium (CPT 84132) at Clay County Medical Center in Clay Center, KS, the facility's cash median price is $32.00, which matches the gross charge listed. This rate is significantly higher than the Medicare benchmark of $4.76, reflecting the standard markup common in commercial healthcare pricing. While the facility is a Critical Access Hospital owned by the local government, the negotiated rates for in-network payers such as Aetna and UnitedHealthcare average $31.00, which is slightly lower than the cash price. For patients with high-deductible plans, paying the cash price of $32.00 upfront could be more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount due to administrative overhead and contract structures.
It is important to note that the facility offers a prompt-pay discount for patients who settle their bill in full, which can further reduce the final cost. Before scheduling, patients should explicitly request a self-pay classification and confirm the availability of prompt-pay rates to avoid automatic claims submission that may void cash discounts. Although the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, patients should always verify their specific plan details and deductible status to ensure they are not facing unexpected out-of-pocket expenses. Given that the facility is located in Clay County, comparing these specific rates to broader state or county averages helps patients understand their position relative to regional pricing norms.