Blood test, potassium
Facility: William Newton Hospital
Billing Code: 84132 (CPT)
- CPT Billing Code: 84132
- Insurance Median: $12
- Cash Discount Price: $33
- vs. Medicare Baseline: 2.52x 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 252% of the Medicare baseline (a markup of 152%). 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 |
|---|---|---|
| UnitedHealthcare | $2 - $30 | 42% |
| Blue Cross Blue Shield | $9 - $12 | 189% |
| Ambetter / Centene | $12 - $33 | 252% |
| Triwest- All Plans | $12 | 252% |
| Providrs Care Nexus | $20 | 420% |
| Providrs Care - All Other Plans | $23 | 483% |
Consumer Guidance & Cost Commentary
For the blood test for potassium (CPT 84132) at William Newton Hospital in Winfield, KS, the cash price is $33.00, which matches the facility's median negotiated rate. This cash price is significantly higher than the Medicare benchmark of $4.76, reflecting a markup common in commercial billing where rates often average 200% to 300% of the federal baseline. While the facility is a Critical Access Hospital with a government-local ownership structure, patients should be aware that commercial negotiated rates can sometimes exceed cash prices due to administrative overhead and contract dynamics. If you have a high-deductible plan, paying the cash price of $33.00 upfront might be more cost-effective than relying on insurance, which could result in a higher allowed amount after your deductible is met.
To maximize savings, we recommend requesting a "prompt-pay" discount from the hospital before scheduling your visit, as paying in full within a short window can reduce the bill by 20% to 50%. Additionally, since the No Surprises Act prohibits balance billing for out-of-network services at in-network facilities, you can avoid unexpected charges even if specific lab components are billed separately. Before finalizing any payment, always request a full itemized bill rather than a summary invoice to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.