CMS Price Transparency Data

Blood test, potassium

Facility: North Adams Regional Hospital Corporation

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84132
  • Insurance Median: $25
  • Cash Discount Price: $40
  • vs. Medicare Baseline: 5.25x Medicare
The contracted insurance negotiated median rate for a Blood test, potassium at North Adams Regional Hospital Corporation is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 5.25x the Medicare baseline. Located in 71 Hospital Avenue, North Adams, MA.
Cash / Self-Pay
$40

Average discount available for prompt cash payment at this facility.

Insurance Median
$25

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: $40 (840%)
Insurance Median: $25 (525%)
Cash: $40 (840% of Medicare)
Ins. Median: $25 (525% 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 525% of the Medicare baseline (a markup of 425%). 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
Mcd Masshealth $4 84%
Mcd New York $4 84%
Mcd Out Of State $4 84%
Mcdmanaged Bmchnp $4 - $5 84%
Mcdmanaged Cdphp $4 84%
Mcdmanaged Hne Mcdaco $4 84%
Medicaid / KanCare $4 - $18 84%
Blue Cross Blue Shield $5 - $36 105%
Comm Hospice $5 - $10 105%
Mcdmanaged Network $5 - $24 105%
Mcr Miscellaneous $5 - $10 105%
Mcrmanaged Cca One Care $5 - $10 105%
Mcrmanaged Usa Family $5 - $10 105%
Mcrmanaged Va $5 - $10 105%
Medicare (plans) $5 - $10 105%
Oth United Vaccn $5 - $10 105%
Aetna $6 - $32 126%
Tricare $6 - $16 126%
Comm Fallon Qhp $7 - $24 147%
Comm Unicare $12 - $27 252%
Comm Network Qhpsub $24 - $25 504%
Wc Workers Comp $25 525%
Comm Network Qhpnonsub $27 - $30 567%
Comm Nhp $27 567%
Comm Hne $28 - $29 588%
Comm Hne Hmo $28 - $31 588%
Comm Hne Ppo $29 - $31 609%
Comm Tufts $33 693%
UnitedHealthcare $36 756%
Cigna $38 - $39 798%
Comm Cdphp $38 798%
Comm Mvp $38 798%
Comm Oxford $38 798%
Comm First Health $39 - $40 819%
Comm Connecticare $40 840%
Comm Consolidated Health $40 840%
Comm Harvard $40 840%
Comm Other $40 840%
Comm Phcs $40 840%
Comm Self Pay $40 840%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 71 Hospital Avenue, North Adams, MA 01247
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Federal
  • Hospital Type: Critical Access Hospitals