CMS Price Transparency Data

Blood test, potassium

Facility: Garnet Health Medical Center

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84132
Insurance Median: $6
Cash Discount Price: $18
vs. Medicare Baseline: 1.26x Medicare

The contracted insurance negotiated median rate for a Blood test, potassium at Garnet Health Medical Center is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 1.26x the Medicare baseline. Located in 707 East Main Street, Middletown, NY.

Cash / Self-Pay

$18

Average discount available for prompt cash payment at this facility.

Insurance Median

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: $18 (378%)

Insurance Median: $6 (126%)

Cash: $18 (378% of Medicare)

Ins. Median: $6 (126% 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.

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
Cigna	$4	84%
Aetna	$5 - $6	105%
Fidelis	$5	105%
UnitedHealthcare	$5	105%
Wellcare	$5	105%
Local 1199	$6	126%
Rojw	$8	168%
Northwell Direct	$10	210%
Geisinger Health Plan	$12	252%
Blue Cross Blue Shield	$13	273%
Mvp	$16	336%

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 $18.
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 Garnet Health Medical Center 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.