CMS Price Transparency Data

Blood test, thyroid (TSH)

Facility: William Newton Hospital

Billing Code: 84443 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84443
  • Insurance Median: $4
  • Cash Discount Price: $6
  • vs. Medicare Baseline: 0.24x Medicare
The contracted insurance negotiated median rate for a Blood test, thyroid (TSH) at William Newton Hospital is $4. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6. Compared to the federal Medicare reimbursement reference rate of $16.8, this hospital’s rate is 0.24x the Medicare baseline. Located in 1300 East Fifth Avenue, Winfield, KS.
Cash / Self-Pay
$6

Average discount available for prompt cash payment at this facility.

Insurance Median
$4

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$16.8

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $16.8 (100%)
Cash / Self-Pay: $6 (36%)
Insurance Median: $4 (24%)
Cash: $6 (36% of Medicare)
Ins. Median: $4 (24% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $16.8 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.

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
Ambetter / Centene $2 - $86 12%
UnitedHealthcare $2 - $77 12%
Blue Cross Blue Shield $2 - $42 12%
Triwest- All Plans $2 - $30 12%
Providrs Care Nexus $3 - $53 18%
Providrs Care - All Other Plans $3 - $60 18%

Consumer Guidance & Cost Commentary

For the CPT code 84443, representing a blood test for thyroid function (TSH), the cash median price at William Newton Hospital in Winfield, KS, is $6.00. This cash rate is significantly lower than the facility's gross charge of $6.00 and aligns with the median negotiated rate of $4.00 across six payers, including Ambetter/Centene, UnitedHealthcare, and Blue Cross Blue Shield. While the facility is a Critical Access Hospital with a government-local ownership structure, patients should be aware that cash payments can sometimes be more cost-effective than using insurance, particularly for those with high-deductible plans where the insurance allowed amount might exceed the cash price. It is advisable to explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as these upfront fee reductions can further lower the total cost by bypassing administrative claim processing fees.

When evaluating the cost relative to national standards, the Medicare benchmark for this service is $16.80, which serves as a scientifically validated baseline for the true cost of care. The facility's cash rate of $6.00 represents a substantial discount compared to the Medicare amount, illustrating the potential savings available through direct payment. However, patients must be cautious regarding balance billing, as the No Surprises Act protects against unexpected out-of-network charges for emergency care and non-emergency services at in-network facilities. If a patient receives an itemized bill that includes services not rendered or unbundled codes, they should request a formal written audit dispute rather than accepting a summary invoice. Ultimately, verifying the specific allowed amount with the insurance carrier before the visit ensures that the patient understands whether the cash option

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