CMS Price Transparency Data

Blood test, thyroid (TSH)

Facility: St James Hospital

Billing Code: 84443 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84443
Insurance Median: $15
Cash Discount Price: $92
vs. Medicare Baseline: 0.89x Medicare

The contracted insurance negotiated median rate for a Blood test, thyroid (TSH) at St James Hospital is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $92. Compared to the federal Medicare reimbursement reference rate of $16.8, this hospital’s rate is 0.89x the Medicare baseline. Located in 411 Canisteo Street, Hornell, NY.

Cash / Self-Pay

$92

Average discount available for prompt cash payment at this facility.

Insurance Median

$15

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$16.8

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $16.8 (100%)

Cash / Self-Pay: $92 (548%)

Insurance Median: $15 (89%)

Cash: $92 (548% of Medicare)

Ins. Median: $15 (89% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $16.8 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
UnitedHealthcare	$7 - $18	42%
Medicaid / KanCare	$8 - $20	48%
Blue Cross Blue Shield	$9 - $33	54%
Fidelis 5155	$9	54%
Molina Healthcare 1723	$9 - $20	54%
Aetna	$12 - $25	71%
Cigna	$13 - $16	77%
Medicare (plans)	$13 - $18	77%
Mvp 2900	$13 - $16	77%
Capital District Physicians Health Plan (Cdphp) 5149	$17	101%
Excellus 2201	$17	101%
Humana	$17	101%
Empire Plan 5179	$20	119%

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 $92.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84443.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St James Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 84443.
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.