CMS Price Transparency Data

Blood test, potassium

Facility: Adena Fayette Medical Center

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84132
Insurance Median: $14
Cash Discount Price: $11
vs. Medicare Baseline: 2.94x Medicare

The contracted insurance negotiated median rate for a Blood test, potassium at Adena Fayette Medical Center is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 2.94x the Medicare baseline. Located in 1430 Columbus Avenue, Washington Ch, OH.

Cash / Self-Pay

$11

Average discount available for prompt cash payment at this facility.

Insurance Median

$14

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: $11 (231%)

Insurance Median: $14 (294%)

Cash: $11 (231% of Medicare)

Ins. Median: $14 (294% 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 294% of the Medicare baseline (a markup of 194%). 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
Blue Cross Blue Shield	$2 - $15	42%
Aetna	$9 - $34	189%
Buckeye Community Health Plan	$9	189%
Care Source	$9	189%
Humana	$9	189%
Medical Mutual Of Ohio	$9 - $17	189%
Medigold	$9	189%
Molina	$9	189%
Molina Marketplace	$10	210%
United Medical Resources Ohcp	$14	294%
UnitedHealthcare	$14	294%
Cigna	$15	315%
Ohio Ppo Connect	$15	315%
The Health Plan	$15	315%
Care Source Just4Me	$16	336%
First Health	$17 - $34	357%
Medical Mutual Of Ohio Supermed	$17	357%
Ohio Health Choice	$17	357%
Multiplan/Private Healthcare Systems	$21	441%
Sidecar Health	$25	525%

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 $11.
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 Adena Fayette 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.