CMS Price Transparency Data

Blood test, potassium

Facility: Pennsylvania Hospital

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84132
  • Insurance Median: $68
  • Cash Discount Price: $141
  • vs. Medicare Baseline: 14.29x Medicare
The contracted insurance negotiated median rate for a Blood test, potassium at Pennsylvania Hospital is $68. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $141. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 14.29x the Medicare baseline. Located in 800 Spruce Street, Philadelphia, PA.
Cash / Self-Pay
$141

Average discount available for prompt cash payment at this facility.

Insurance Median
$68

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: $141 (2962%)
Insurance Median: $68 (1429%)
Cash: $141 (2962% of Medicare)
Ins. Median: $68 (1429% 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 1429% of the Medicare baseline (a markup of 1329%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 - $144 42%
Ibc Commercial Hpn $2 42%
Keystone Hmo Proactive $2 42%
Cigna $3 - $49 63%
Aetna $5 - $144 105%
Clover Health Plan $5 105%
Geisinger Health Plan $5 - $15 105%
Health Partners $5 - $144 105%
Humana $5 - $115 105%
Ibc $5 105%
Keystone First $5 105%
Medicare (plans) $5 105%
Pa Health And Wellness $5 - $8 105%
Penn Life (Living Independently For Elders) $5 105%
Philadelphia Va Medical Center $5 105%
Tricare $5 105%
UnitedHealthcare $5 - $144 105%
Upmc $5 - $144 105%
Us Family Health Plan $5 105%
Gateway Health Plan $6 126%
Medicaid / KanCare $6 - $144 126%
Pa Medical Assistance $6 126%
Elap $7 147%
Claims Watcher $8 - $9 168%
Keystone Mercy Health Plan $8 168%
Oscar Health Plan $8 168%
Centivo $9 189%
Elap Services $9 189%
Highmark $10 210%
Penn Global Medicine $13 273%
Horizon Nj Health $23 - $25 483%
Pgm - Regie De L'Assurance Maladie Quebec $32 - $33 672%
Preferred Health Care Eliance $36 - $37 756%
Pgm - Kuwait Defense $48 - $65 1008%
Devon $52 - $65 1092%
Qualcare $52 - $55 1092%
Coventry $55 - $73 1155%
Pgm - Chop $55 - $58 1155%
Wissahickon Hospice $55 - $58 1155%
Healthamerica/Coventry $62 - $71 1303%
Olympus $67 - $70 1408%
First Health Global $69 - $72 1450%
Urn-Cancer Resource Services $69 - $72 1450%
Health Net $83 - $86 1744%
Pgm - Royal Embassy Of Saudi Arabia $83 - $86 1744%
Pgm - Embassy Of Qatar $90 - $94 1891%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $90 - $94 1891%
Pgm - Embassy Of The United Emirates/Ipc $97 - $101 2038%
Devon Health Services Inc $110 - $115 2311%
Health America/Ccn $110 - $115 2311%
Intergroup $110 - $115 2311%
Pgm - Kuwait Health Division $110 - $115 2311%
Pgm - Kuwait Oil $110 - $115 2311%
Preferred Care $110 - $115 2311%
Commercial Other $138 - $144 2899%
Community Behavioral Health $138 - $144 2899%
International Pfs $138 - $144 2899%
Quest Behavioral Health $138 - $144 2899%
United Behavioral Health $138 - $144 2899%
Workers Compensation $138 - $144 2899%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals