Blood test, potassium
Facility: Memorial Hospital
Billing Code: 84132 (CPT)
- CPT Billing Code: 84132
- Insurance Median: $30
- Cash Discount Price: $55
- 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 |
|---|---|---|
| Blue Cross Blue Shield | $7 | 147% |
| Tricare | $28 | 588% |
| Medicare (plans) | $28 | 588% |
| Humana | $28 | 588% |
| Ambetter / Centene | $30 | 630% |
| Coventry - All Other Plans | $50 | 1050% |
| Preferred Healthcare-All Plans | $52 | 1092% |
| Health Partners Of Kansas - All Plans | $52 | 1092% |
| Wppa/Providers Care-All Plans | $77 | 1618% |
Consumer Guidance & Cost Commentary
For the blood test, potassium procedure at Memorial Hospital in Abilene, KS, the cash price is $55.00, which matches the facility's median negotiated rate of $30.00 when adjusted for the specific payer mix and represents a 6.3% increase over the Medicare benchmark of $4.76. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. In this specific case, the cash price is identical to the gross charge, meaning there is no discount available for paying out-of-pocket at the standard rate, though patients with high-deductible plans might find the cash price more predictable if their insurance allowed amount exceeds this figure.
To minimize potential costs, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can bypass costly insurance billing cycles and administrative fees. It is also important to request a full itemized bill containing specific CPT codes rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled charges that can be disputed in writing. Since the facility is in-network for nine major payers including Blue Cross Blue Shield and Medicare, the No Surprises Act generally protects patients from balance billing for emergency or non-emergency services, but patients should still verify their plan's specific deductible status and allowed amounts to ensure they are not paying more than necessary.