CMS Price Transparency Data

Blood test, potassium

Facility: Lexington Memorial Hospital Inc

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84132
  • Insurance Median: $26
  • Cash Discount Price: $30
  • vs. Medicare Baseline: 5.46x Medicare
The contracted insurance negotiated median rate for a Blood test, potassium at Lexington Memorial Hospital Inc is $26. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 5.46x the Medicare baseline. Located in 250 Hospital Drive Po Box 1817, Lexington, NC.
Cash / Self-Pay
$30

Average discount available for prompt cash payment at this facility.

Insurance Median
$26

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: $30 (630%)
Insurance Median: $26 (546%)
Cash: $30 (630% of Medicare)
Ins. Median: $26 (546% 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 546% of the Medicare baseline (a markup of 446%). 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
Amerihealth $8 - $9 168%
Carolina Complete $8 168%
Healthy Blue $8 168%
Partners $8 168%
UnitedHealthcare $8 - $26 168%
Vaya $8 168%
Wellcare $8 168%
Alliance $9 189%
Ambetter / Centene $9 189%
Blue Cross Blue Shield $9 - $14 189%
Trillium $9 189%
Medcost $13 - $39 273%
Aetna $17 - $55 357%
Oscar $19 - $26 399%
Cigna $26 546%
Directnet $35 735%
Healthgram Lexington Home Brands $42 882%
Healthgram $47 987%
Private Healthcare Systems $48 1008%
Beechstreet $52 1092%
Humana $52 1092%
Multiplan $53 1113%
National Provider Network $53 1113%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 250 Hospital Drive Po Box 1817, Lexington, NC 27293
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals