CMS Price Transparency Data

Blood test, potassium

Facility: Boston Children's Hospital

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84132
Insurance Median: $58
Cash Discount Price: $82
vs. Medicare Baseline: 12.18x Medicare

The contracted insurance negotiated median rate for a Blood test, potassium at Boston Children's Hospital is $58. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $82. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 12.18x the Medicare baseline. Located in 300 Longwood Avenue, Boston, MA.

Cash / Self-Pay

$82

Average discount available for prompt cash payment at this facility.

Insurance Median

$58

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: $82 (1723%)

Insurance Median: $58 (1218%)

Cash: $82 (1723% of Medicare)

Ins. Median: $58 (1218% 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 1218% of the Medicare baseline (a markup of 1118%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$17 - $54	357%
Unicare	$18	378%
Cdphp	$40 - $70	840%
Harvard Pilgrim	$42 - $55	882%
Aetna	$49 - $69	1029%
United	$49 - $69	1029%
Mgb/Allways	$50 - $61	1050%
Tufts Public Plan	$50	1050%
Ambetter / Centene	$52	1092%
United Ri Nj Ny	$52	1092%
Carelon Strategies/Bhs	$53	1113%
UnitedHealthcare	$53 - $70	1113%
Carelon/Beacon	$62	1303%
Fallon	$63	1324%
Health New England	$66	1387%
Cigna	$70 - $74	1471%
Ets/Lifetrac	$70	1471%
Interlink Transplant	$70	1471%
Community Health Options	$74	1555%
Humana	$74	1555%
Coventry/Hcvm/First Health	$75	1576%
Multiplan/Phcs	$75 - $78	1576%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $82.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84132.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Boston Children's Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 84132.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.