CMS Price Transparency Data

Blood test, magnesium

Facility: Morris County Hospital

Billing Code: 83735 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83735
  • Insurance Median: $44
  • Cash Discount Price: $68
  • vs. Medicare Baseline: 6.57x Medicare
The contracted insurance negotiated median rate for a Blood test, magnesium at Morris County Hospital is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $68. Compared to the federal Medicare reimbursement reference rate of $6.7, this hospital’s rate is 6.57x the Medicare baseline. Located in 600 N Washington St, Council Grove, KS.
Cash / Self-Pay
$68

Average discount available for prompt cash payment at this facility.

Insurance Median
$44

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$6.7

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $6.7 (100%)
Cash / Self-Pay: $68 (1015%)
Insurance Median: $44 (657%)
Cash: $68 (1015% of Medicare)
Ins. Median: $44 (657% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $6.7 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 657% of the Medicare baseline (a markup of 557%). 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
Providrs Care (Wppa)(Nexus)-All Plans $7 104%
Aetna $7 104%
Va Ccn-All Plans $8 119%
Blue Cross Blue Shield $25 - $44 373%
Choice Care Mcr Adv-All Plans $44 657%
UnitedHealthcare $44 - $114 657%
Coventry Mcr $44 657%
Cigna $82 1224%
Coventry Comm-All Other Plans $103 1537%
Multiplan-All Plans $103 1537%

Consumer Guidance & Cost Commentary

For the blood test, magnesium procedure (CPT 83735) at Morris County Hospital in Council Grove, Kansas, the facility's cash median rate is $68.00, while the median negotiated rate for in-network payers is $44.00. This suggests that for patients with high-deductible plans, paying cash upfront could be more cost-effective than relying on insurance, as the negotiated rate exceeds the cash price. However, patients should verify if the hospital offers "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid in full within 30 days, potentially bringing the final cost below the cash median. It is crucial to request self-pay classification and a waiver of insurance submission before scheduling to ensure these discounts apply and to avoid automatic claims processing that might void the cash agreement.

The facility's Medicare benchmark amount is $6.70, which serves as a baseline for evaluating pricing fairness. While the gross charge for this service is $114.00, the negotiated rates across various payers range from $7.00 to $114.00, with many plans settling at the $44.00 median. Although the provided data does not include specific county or state average figures for comparison, the significant gap between the gross charge and the Medicare rate highlights the importance of comparing rates against federal benchmarks rather than the hospital's full list price. Patients are advised to review their specific plan details to understand their out-of-pocket responsibilities and to dispute any balance billing if they encounter unexpected charges from out-of-network providers, as federal protections may apply.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 N Washington St, Council Grove, KS 66846
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals