CMS Price Transparency Data

Blood test, potassium

Facility: Tomah Memorial Hospital

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84132
  • Insurance Median: $28
  • Cash Discount Price: $47
  • vs. Medicare Baseline: 5.88x Medicare
The contracted insurance negotiated median rate for a Blood test, potassium at Tomah Memorial Hospital is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 5.88x the Medicare baseline. Located in 501 Gopher Dr, Tomah, WI.
Cash / Self-Pay
$47

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

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: $47 (987%)
Insurance Median: $28 (588%)
Cash: $47 (987% of Medicare)
Ins. Median: $28 (588% 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 588% of the Medicare baseline (a markup of 488%). 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
Va Ccn - All Plans $4 84%
Blue Cross Blue Shield $7 - $75 147%
Independent Care Mcaid $7 147%
Managed Hlth Mcaid - All Plans $7 147%
Quartz Mcaid $7 147%
Security Hp Mcaid $7 147%
Group Hlth Mcr Adv - All Plans $28 588%
Humana $28 - $76 588%
Independent Care Mcr - All Other Plans $28 588%
Quartz Mcr Adv $28 588%
Security Hp Mcr Adv $28 588%
UnitedHealthcare $28 - $77 588%
Aetna $53 - $70 1113%
Cigna $62 - $80 1303%
Security Hp Comm - All Other Plans $70 1471%
Quartz Comm - All Other Plans $74 1555%
The Alliance - All Plans $76 1597%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 501 Gopher Dr, Tomah, WI 54660
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals