CMS Price Transparency Data

Blood test, potassium

Facility: Pender Memorial Hospital

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84132
Insurance Median: $43
Cash Discount Price: $36
vs. Medicare Baseline: 9.03x Medicare

The contracted insurance negotiated median rate for a Blood test, potassium at Pender Memorial Hospital is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 9.03x the Medicare baseline. Located in 507 E Fremont St, Burgaw, NC.

Cash / Self-Pay

$36

Average discount available for prompt cash payment at this facility.

Insurance Median

$43

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: $36 (756%)

Insurance Median: $43 (903%)

Cash: $36 (756% of Medicare)

Ins. Median: $43 (903% 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 903% of the Medicare baseline (a markup of 803%). 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
Humana	$16 - $83	336%
Aetna	$17 - $82	357%
Blue Cross Blue Shield	$17 - $69	357%
Carolina Complete	$17 - $27	357%
Cigna	$17 - $42	357%
Nc Department Of Public Safety	$17 - $52	357%
New Hanover Health	$17 - $26	357%
Pace Of The Southern Piedmont	$17 - $26	357%
Amerihealth	$18 - $28	378%
Wellcare	$18 - $28	378%
Ambetter / Centene	$23 - $36	483%
Liberty Health	$24 - $37	504%
Caresource North Carolina	$25 - $38	525%
Plotkin Health	$37 - $58	777%
UnitedHealthcare	$45 - $70	945%
Medcost	$47 - $81	987%
Employers Choice Network	$60 - $93	1261%
Three Rivers Provider Network	$60 - $93	1261%

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 $36.
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 Pender Memorial 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.