CMS Price Transparency Data

Blood test, potassium

Facility: Mercy Hospital Carthage

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84132
Insurance Median: $36
Cash Discount Price: $43
vs. Medicare Baseline: 7.56x Medicare

The contracted insurance negotiated median rate for a Blood test, potassium at Mercy Hospital Carthage is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 7.56x the Medicare baseline. Located in 3125 Dr Russell Smith Way, Carthage, MO.

Cash / Self-Pay

$43

Average discount available for prompt cash payment at this facility.

Insurance Median

$36

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: $43 (903%)

Insurance Median: $36 (756%)

Cash: $43 (903% of Medicare)

Ins. Median: $36 (756% 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 756% of the Medicare baseline (a markup of 656%). 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
Aetna	$4 - $59	84%
Blue Cross Blue Shield	$4 - $18	84%
Humana	$4 - $20	84%
Medicaid / KanCare	$4 - $36	84%
Medicare (plans)	$5 - $20	105%
United Medical Resources Contracted [320454]	$6 - $59	126%
UnitedHealthcare	$6 - $57	126%
Cherokee Nation Health Serv Contracted [320066]	$18	378%
Cigna	$18 - $59	378%
Cross Timbers Hospice [20098]	$18	378%
Dept Of Veteran Affairs Contracted [320106]	$18	378%
Elara Caring Aspire Hospice [20433]	$18	378%
Globalhealth Contracted [320145]	$18	378%
Halo Hcr Inc Hospice Contracted [320432]	$18	378%
Halo Hcr Inc Hospice [20432]	$18	378%
Indian Health Service Contracted [320198]	$18	378%
Kindful Hospice Contracted [320434]	$18	378%
Kindful Hospice [20434]	$18	378%
Medical Associates Health Contracted [320444]	$18	378%
Mercy Hospice Okc [20252]	$18	378%
Mercy Mgd Behavioral Health Contracted [320259]	$18	378%
Pace Of The Ozarks Contracted [320518]	$18	378%
Provider Partners Health Plans Contracted [320450]	$18	378%
Qual Choice Contracted [320325]	$18	378%
Tricare	$18	378%
Point C Contracted [320238]	$23 - $59	483%
Health Systems Inc Contracted [320174]	$28	588%
Insurance System Inc Contracted [320465]	$28	588%
Administrative Payor Contracted [320005]	$30	630%
Centivo Contracted [320505]	$30	630%
Healthscope Contracted [320182]	$34	714%
Ambetter / Centene	$36	756%
Home State Health Plan Contracted [320187]	$36	756%
Novasys Contracted [320285]	$36	756%
Benefit Management Contracted [320052]	$40 - $57	840%
Auxiant Contracted [320462]	$43 - $56	903%
Healthlink Contracted [320179]	$43 - $61	903%
Preferred Health Plan Contracted [320522]	$43	903%
Workers Comp [20426]	$53 - $66	1113%
90 Degree Benefits Contracted [320436]	$56	1176%
Aither Health Contracted [320449]	$56	1176%
Ebms Contracted [320493]	$56	1176%
Edison Health Solutions Contracted [320502]	$56	1176%
Imagine 360 Contracted [320494]	$56	1176%
Mercy Benefit Admin Contracted [320251]	$56 - $59	1176%
Reflect Health Contracted [320492]	$56	1176%
Show-Me Health Administrators Contracted [320483]	$56	1176%
Yuzu Health Contracted [320521]	$56	1176%
Evolutions Health Care Contracted [320124]	$57	1197%
First Health Contracted [320128]	$57	1197%
Medica Contracted [320239]	$57	1197%
Multiplan Contracted [320270]	$57	1197%
Private Health Care Systems Contracted [320320]	$57	1197%
American Healthcare Alliance Contracted [320020]	$59	1239%
Ppo Plus Contracted [320310]	$59	1239%
Usa Managed Care Org Contracted [320429]	$59	1239%

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 $43.
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 Mercy Hospital Carthage 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.