Blood test, calcium
Facility: Aurora Medical Center
Billing Code: 82310 (CPT)
- CPT Billing Code: 82310
- Insurance Median: $15
- Cash Discount Price: $50
- vs. Medicare Baseline: 2.91x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $5.16 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 291% of the Medicare baseline (a markup of 191%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $4 - $84 | 78% |
| Aurora Caregiver | $5 | 97% |
| Blue Cross Blue Shield | $5 - $85 | 97% |
| Centivo | $11 | 213% |
| Common Ground | $11 | 213% |
| Aetna | $12 - $83 | 233% |
| Health Payment Systems | $13 | 252% |
| Quartz One | $13 | 252% |
| Healthpartners | $14 - $75 | 271% |
| Molina Exchange | $14 | 271% |
| Cigna | $15 - $85 | 291% |
| Everpointe Elite | $15 | 291% |
| Hs Technology | $15 | 291% |
| Quartz Group | $15 | 291% |
| Wisconsin Physician Service | $17 - $18 | 329% |
| Trilogy | $18 | 349% |
| Health Eos Plus | $60 | 1163% |
| Health Eos | $80 | 1550% |
Consumer Guidance & Cost Commentary
For patients considering self-pay, the most important takeaway is that paying cash directly can often be significantly cheaper than relying on insurance, which typically incurs higher administrative costs and negotiated rates. At Aurora Medical Center in Grafton, the cash median rate for this blood test is $50, which is notably lower than the state average of $100. While commercial insurance plans generally pay negotiated rates—such as UnitedHealthcare's range of $4 to $84 or Aetna's $12 to $11—these amounts frequently exceed the cash price, especially for patients with high deductibles. It is essential to verify if your specific plan qualifies for in-network pricing before scheduling, as assuming that being in-network guarantees the lowest possible cost is a common pitfall.
Beyond individual plan rates, it is helpful to understand how commercial pricing compares to federal benchmarks to gauge overall value. The facility's gross chargemaster rate of $100 serves as the starting point, but the actual cost paid by insurers like Blue Cross Blue Shield ($5 to $85) and Cigna ($15 to $85) often reflects the administrative overhead and contract dynamics inherent in the insurance system. For context, the Medicare amount for this service is $5.16, which acts as a reliable baseline for evaluating the markup of commercial rates; for instance, the facility's negotiated rates are roughly 2.9 times the Medicare amount. Patients should also inquire about "prompt-pay" discounts, which can offer further reductions if bills are settled upfront, and always request an itemized bill to ensure no unexpected charges are included before finalizing payment.