CMS Price Transparency Data

Blood test, potassium

Facility: UMass Memorial Healthalliance Hospitals

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84132
  • Insurance Median: $12
  • Cash Discount Price: $47
  • vs. Medicare Baseline: 2.52x Medicare
The contracted insurance negotiated median rate for a Blood test, potassium at UMass Memorial Healthalliance Hospitals is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 2.52x the Medicare baseline. Located in 60 Hospital Road, Leominster, MA.
Cash / Self-Pay
$47

Average discount available for prompt cash payment at this facility.

Insurance Median
$12

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$4.76

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.76 (100%)
Cash / Self-Pay: $47 (987%)
Insurance Median: $12 (252%)
Cash: $47 (987% of Medicare)
Ins. Median: $12 (252% of 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.

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
Medicaid / KanCare $4 - $6 84%
Aetna $5 - $32 105%
Blue Cross Blue Shield $5 - $12 105%
Champva [11001] $5 105%
Cigna $5 - $18 105%
Commonwealth Care Mcr [10115] $5 105%
Fallon Mcr Supp [20202] $5 105%
Harvard Pilgrim Mcr [10106] $5 105%
Institution [10406] $5 - $26 105%
Medicare (plans) $5 105%
Mgb Mcr [10124] $5 105%
Senior Whole Health [10110] $5 105%
Tufts Dual [10111] $5 105%
Tufts Mcr [10112] $5 105%
Tufts Us Family [11203] $5 105%
UnitedHealthcare $5 - $49 105%
Correctional Care [11003] $6 - $8 126%
Masshealth [20302] $6 126%
Workers Compensation [20501] $6 126%
Tufts Connectorcare [10507] $8 168%
Tufts [11201] $10 210%
Harvard Pilgrim [10701] $12 - $14 252%
Wellpoint [11112] $12 252%
Hne [11108] $25 - $27 525%
First Health Network [11120] $34 - $37 714%
Multiplan [11109] $34 - $37 714%
Connecticare [11105] $45 - $49 945%
Fallon Carelon Hlth [28] $45 - $49 945%
Fallon Connectorcare [10503] $45 945%
Fallon Mcaid Carelon Hlth [29] $45 - $49 945%
Grants [20507] $45 - $49 945%
Hsno/Free Care [10801] $294 6176%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 60 Hospital Road, Leominster, MA 01453
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals