CMS Price Transparency Data

Blood test, amylase

Facility: William Newton Hospital

Billing Code: 82150 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82150
  • Insurance Median: $32
  • Cash Discount Price: $66
  • vs. Medicare Baseline: 4.94x Medicare
The contracted insurance negotiated median rate for a Blood test, amylase at William Newton Hospital is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $66. Compared to the federal Medicare reimbursement reference rate of $6.48, this hospital’s rate is 4.94x the Medicare baseline. Located in 1300 East Fifth Avenue, Winfield, KS.
Cash / Self-Pay
$66

Average discount available for prompt cash payment at this facility.

Insurance Median
$32

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$6.48

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $6.48 (100%)
Cash / Self-Pay: $66 (1019%)
Insurance Median: $32 (494%)
Cash: $66 (1019% of Medicare)
Ins. Median: $32 (494% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $6.48 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 494% of the Medicare baseline (a markup of 394%). 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
UnitedHealthcare $4 - $81 62%
Triwest- All Plans $23 - $31 355%
Ambetter / Centene $23 - $90 355%
Blue Cross Blue Shield $23 - $32 355%
Providrs Care Nexus $39 - $55 602%
Providrs Care - All Other Plans $45 - $63 694%

Consumer Guidance & Cost Commentary

For this blood test procedure at William Newton Hospital in Winfield, KS, the cash price is $66.00, which matches the facility's median negotiated rate. While the hospital is an in-network Critical Access Hospital with government ownership, 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 median negotiated amount is also $32.00, which is lower than the cash price, suggesting that using insurance may result in a lower out-of-pocket cost for those with active coverage. However, for patients with high-deductible plans who have not yet met their deductible, paying the cash price directly could be more cost-effective than facing a balance bill for the difference between the provider's full charge and the insurance allowed amount.

To ensure you are not overcharged, it is crucial to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, patients should verify their specific plan details, as the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, but emergency ancillary services may still trigger unexpected charges if not properly coordinated. Finally, always ask the billing department about self-pay or prompt-pay discounts before scheduling, as paying in full upfront can sometimes bypass insurance processing and secure a lower rate, though in this instance, the negotiated rate is already competitive with the cash price.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1300 East Fifth Avenue, Winfield, KS 67156
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals