CMS Price Transparency Data

Blood test, potassium

Facility: Nationwide Children's Hospital Toledo, LLC

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84132
Insurance Median: $50
Cash Discount Price: $80
vs. Medicare Baseline: 10.50x Medicare

The contracted insurance negotiated median rate for a Blood test, potassium at Nationwide Children's Hospital Toledo, LLC is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 10.50x the Medicare baseline. Located in 2213 Cherry Street, Toledo, OH.

Cash / Self-Pay

$80

Average discount available for prompt cash payment at this facility.

Insurance Median

$50

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: $80 (1681%)

Insurance Median: $50 (1050%)

Cash: $80 (1681% of Medicare)

Ins. Median: $50 (1050% 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 1050% of the Medicare baseline (a markup of 950%). 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
Caresource	$5	105%
Mcclaren Health Plan - Michigan	$5	105%
Molina	$5 - $13	105%
Cigna	$7	147%
Amerihealth	$13	273%
Bchp	$13	273%
Blue Cross Blue Shield	$13 - $73	273%
Humana	$13	273%
UnitedHealthcare	$13 - $73	273%
Front Path Health Coalition	$14 - $65	294%
Mmo	$31 - $50	651%
Aetna	$47 - $55	987%
Mcclaren Health Plan	$55 - $65	1155%
Ohc	$62 - $72	1303%
Ohio Ppo Connect	$62 - $72	1303%
First Health	$95 - $111	1996%

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 $80.
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 Nationwide Children's Hospital Toledo, LLC 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.