CMS Price Transparency Data

Blood test, potassium

Facility: Baylor Scott & White the Heart Hospital Plano

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84132
Insurance Median: $20
Cash Discount Price: $55
vs. Medicare Baseline: 4.20x Medicare

The contracted insurance negotiated median rate for a Blood test, potassium at Baylor Scott & White the Heart Hospital Plano is $20. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $55. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 4.20x the Medicare baseline. Located in 1100 Allied Drive, Plano, TX.

Cash / Self-Pay

$55

Average discount available for prompt cash payment at this facility.

Insurance Median

$20

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: $55 (1155%)

Insurance Median: $20 (420%)

Cash: $55 (1155% of Medicare)

Ins. Median: $20 (420% 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 420% of the Medicare baseline (a markup of 320%). 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
Aetna	$5 - $51	105%
American Health Plan	$5	105%
Baylor Scott & White Health Plan	$5 - $54	105%
Blue Cross Blue Shield	$5 - $23	105%
Corvel	$5	105%
Healthspring	$5	105%
Humana	$5 - $65	105%
Prime Health Services	$5	105%
Procare Advantage	$5	105%
Superior Health Plan	$5 - $18	105%
Triwest	$5	105%
UnitedHealthcare	$5 - $11	105%
Ambetter / Centene	$10	210%
Cigna	$46 - $54	966%
Employers Health Network	$51	1071%
Quiktrip	$51	1071%
University Of Mary Hardin-Baylor	$54	1134%
Imagine Health	$58	1218%
Curative	$60	1261%
First Health	$65	1366%
Healthsmart	$65 - $69	1366%
Private Health Care System	$69	1450%

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 $55.
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 Baylor Scott & White the Heart Hospital Plano 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.