CMS Price Transparency Data

Blood test, potassium

Facility: Holy Family Memorial

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84132
  • Insurance Median: $15
  • Cash Discount Price: $16
  • vs. Medicare Baseline: 3.15x Medicare
The contracted insurance negotiated median rate for a Blood test, potassium at Holy Family Memorial is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 3.15x the Medicare baseline. Located in 2300 Western Ave, Manitowoc, WI.
Cash / Self-Pay
$16

Average discount available for prompt cash payment at this facility.

Insurance Median
$15

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: $16 (336%)
Insurance Median: $15 (315%)
Cash: $16 (336% of Medicare)
Ins. Median: $15 (315% 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 315% of the Medicare baseline (a markup of 215%). 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
Allwell $5 105%
Blue Cross Blue Shield $5 - $6 105%
Community Care Incorporated $5 105%
Health Partners $5 - $19 105%
Humana $5 105%
Icare $5 105%
Molina $5 105%
Network Health Plan $5 - $16 105%
Security Health Plan $5 - $23 105%
UnitedHealthcare $5 - $6 105%
Medical College Of Wisconsin $10 210%
Centivo $12 - $13 252%
Health Payment Systems $12 252%
Chorus Community Health Plan $13 273%
Dean Health Plan $14 294%
Sheboygan Employers Health Network $17 357%
Trilogy $19 399%
Cigna $21 441%
Wps Health Plan $21 441%
Aspirus $23 483%
Healtheos $23 483%
Multiplan/Private Healthcare Systems $23 483%
Preferred One $23 483%
Healthsmart $24 504%
First Health Network $26 546%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2300 Western Ave, Manitowoc, WI 54221
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals