Blood test, thyroid (TSH)
Facility: Smith County Memorial Hospital
Billing Code: 84443 (CPT)
- CPT Billing Code: 84443
- Insurance Median: $63
- Cash Discount Price: $68
- vs. Medicare Baseline: 3.75x 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 375% of the Medicare baseline (a markup of 275%). 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 | 262% |
| Medicaid / KanCare | $47 - $68 | 280% |
| Multiplan-All Plans | $61 | 363% |
| Wppa-All Plans | $63 | 375% |
| Midlands Choice-All Plans | $64 | 381% |
| UnitedHealthcare | $64 | 381% |
| Health Partners Of Ks Ppo-All Plans | $64 | 381% |
Consumer Guidance & Cost Commentary
For the blood test procedure (CPT 84443) at Smith County Memorial Hospital in Smith Center, Kansas, the cash price is $68.00, which matches the facility's gross charge and the median cash rate reported for this service. This cash price is significantly lower than the negotiated rates paid by most insurance payers, with the median negotiated amount being $63.00 and the highest negotiated rate reaching $68.00. While the facility is a Critical Access Hospital with government-local ownership, patients with high-deductible plans or those without insurance may find the cash price more affordable than their insurance coverage, as the negotiated rates often exceed the cash price. It is important to note that while the facility offers a cash rate, patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final cost by bypassing administrative fees associated with insurance billing.
When evaluating the cost against federal standards, the Medicare benchmark for this service is $16.80, which serves as the objective baseline for pricing. The facility's cash rate of $68.00 represents a substantial markup over the Medicare amount, illustrating how commercial rates can differ significantly from the government's cost-based reimbursement. Additionally, the median amount paid by insurance payers is $61.00, which is slightly higher than the Medicare rate but still lower than the gross charge. For consumers concerned about balance billing, it is crucial to understand that the No Surprises Act protects patients from being billed the difference between the provider's full charge and the insurance allowed amount for emergency care or non-emergency services from out-of-network providers at in-network facilities