CMS Price Transparency Data

Blood test, potassium

Facility: St Josephs Community Hospital West Bend

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84132
  • Insurance Median: $27
  • Cash Discount Price: $35
  • vs. Medicare Baseline: 5.67x Medicare
The contracted insurance negotiated median rate for a Blood test, potassium at St Josephs Community Hospital West Bend is $27. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 5.67x the Medicare baseline. Located in 3200 Pleasant Valley Road, West Bend, WI.
Cash / Self-Pay
$35

Average discount available for prompt cash payment at this facility.

Insurance Median
$27

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: $35 (735%)
Insurance Median: $27 (567%)
Cash: $35 (735% of Medicare)
Ins. Median: $27 (567% 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 567% of the Medicare baseline (a markup of 467%). 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
Aetna $5 - $46 105%
Allwell $5 105%
Blue Cross Blue Shield $5 - $24 105%
Care Wisconsin $5 105%
Community Care $5 105%
Health Partners $5 - $43 105%
Humana $5 105%
Icare $5 105%
Molina $5 105%
Network Health Plan $5 - $6 105%
Security Health Plan Secure Savers $5 105%
UnitedHealthcare $5 - $22 105%
Centivo $6 - $22 126%
Sheboygan Employers Health Network $6 126%
Froedtert South $8 - $28 168%
Chorus Community Health Plan $9 - $28 189%
Common Ground $12 - $40 252%
Health Payment Systems $13 - $53 273%
Trilogy $16 - $54 336%
Wisconsin Physician Services $16 - $53 336%
Americas Choice $17 - $57 357%
Healtheos $17 - $57 357%
Multiplan/Private Healthcare Systems $17 - $57 357%
First Health Network $18 - $58 378%
Hfn $18 - $59 378%
Ibsi Passport $18 - $59 378%
Cigna $19 - $63 399%
Healthsmart $19 - $63 399%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3200 Pleasant Valley Road, West Bend, WI 53095
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals