Blood test, potassium
Facility: Morris County Hospital
Billing Code: 84132 (CPT)
- CPT Billing Code: 84132
- Insurance Median: $30
- Cash Discount Price: $47
- vs. Medicare Baseline: 6.30x 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 630% of the Medicare baseline (a markup of 530%). 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 |
|---|---|---|
| Va Ccn-All Plans | $4 | 84% |
| Providrs Care (Wppa)(Nexus)-All Plans | $5 | 105% |
| Aetna | $6 | 126% |
| Blue Cross Blue Shield | $9 - $30 | 189% |
| Choice Care Mcr Adv-All Plans | $30 | 630% |
| UnitedHealthcare | $30 - $78 | 630% |
| Coventry Mcr | $30 | 630% |
| Cigna | $56 | 1176% |
| Multiplan-All Plans | $70 | 1471% |
| Coventry Comm-All Other Plans | $70 | 1471% |
Consumer Guidance & Cost Commentary
For this blood test for potassium at Morris County Hospital in Council Grove, KS, the cash median price is $47.00, which is lower than the negotiated rates paid by most major insurers. While the facility's cash rate is significantly below the gross charge of $78.00, commercial payers such as UnitedHealthcare and Blue Cross Blue Shield have negotiated rates ranging from $30.00 to $78.00, meaning patients with high-deductible plans might find paying out-of-pocket cheaper than relying on insurance. It is important to note that while the facility is a Critical Access Hospital owned by the local government, patients should verify their specific plan details, as some in-network contracts may result in higher allowed amounts than the cash price.
The Medicare benchmark for this service is $4.76, which serves as a baseline for evaluating the facility's pricing markup. Although the facility's rating is 3, the data indicates that the negotiated rates for this test are generally aligned with or exceed the Medicare amount, reflecting standard administrative costs and provider fees. Patients should be aware that balance billing is largely prohibited for emergency services and non-emergency care at in-network facilities under the No Surprises Act, but it is crucial to request an itemized billing audit if unexpected charges appear. Additionally, asking about prompt-pay discounts before scheduling can help secure immediate cash discounts, bypassing the administrative overhead associated with insurance claims processing.