Blood test, potassium
Facility: Smith County Memorial Hospital
Billing Code: 84132 (CPT)
- CPT Billing Code: 84132
- Insurance Median: $19
- Cash Discount Price: $20
- vs. Medicare Baseline: 3.99x 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 399% of the Medicare baseline (a markup of 299%). 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 | 210% |
| Medicaid / KanCare | $14 - $20 | 294% |
| Multiplan-All Plans | $18 | 378% |
| UnitedHealthcare | $19 | 399% |
| Health Partners Of Ks Ppo-All Plans | $19 | 399% |
| Midlands Choice-All Plans | $19 | 399% |
| Wppa-All Plans | $19 | 399% |
Consumer Guidance & Cost Commentary
For this blood test for potassium at Smith County Memorial Hospital in Smith Center, KS, the cash price is $20.00, which matches the facility's gross charge and the median cash rate. This amount is significantly lower than the negotiated rates paid by major insurers like Blue Cross Blue Shield ($10.00) and Medicaid/KanCare ($14.00 to $20.00), as well as UnitedHealthcare and others ($19.00). While these insurance plans have contractual ceilings that limit what they pay, the cash price remains the most transparent figure for patients. It is important to note that for patients with high-deductible plans, paying the cash price of $20.00 upfront can be more cost-effective than relying on insurance, especially if the insurer's negotiated rate exceeds the cash price or if the patient has not yet met their deductible.
The facility, a Critical Access Hospital owned by the local government, bills at a rate that is 4.0% higher than the Medicare benchmark of $4.76, reflecting the specific cost structure of this service. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network emergency care, it does not automatically apply to all ancillary services like lab tests unless specific conditions are met. To maximize savings, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these programs can offer further reductions by bypassing insurance claims processing. Additionally, if a bill is ever received, patients should request a full itemized audit to ensure no unbundled codes or services not rendered are included, as summary bills often obscure the true cost of care.