Blood test, potassium
Facility: Northeast Regional Medical Center
Billing Code: 84132 (CPT)
- CPT Billing Code: 84132
- Insurance Median: $89
- Cash Discount Price: $99
- vs. Medicare Baseline: 18.70x 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 $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 1870% of the Medicare baseline (a markup of 1770%). 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 |
|---|---|---|
| Node Champva | $4 | 84% |
| Tricare | $4 | 84% |
| Medicaid / KanCare | $4 - $7 | 84% |
| Veterans Eval Services | $5 | 105% |
| Blue Pathway/Pathway X | $5 | 105% |
| Blue Prefrerred | $5 | 105% |
| Node Hospice Non Par Agree | $5 | 105% |
| Node Devoted Health McR Adv | $5 | 105% |
| Node VA | $5 | 105% |
| Medicare (plans) | $5 | 105% |
| Blue Cross Blue Shield | $5 - $76 | 105% |
| UnitedHealthcare | $5 - $187 | 105% |
| Blue Access | $5 | 105% |
| Centurion Correctional | $6 | 126% |
| Us Department of Labor | $6 | 126% |
| Home State Exchange | $9 | 189% |
| Naphcare | $9 | 189% |
| Immergrun | $10 | 210% |
| Self Pay | $60 - $137 | 1261% |
| Cigna | $85 - $98 | 1786% |
| Aetna | $93 - $208 | 1954% |
| Access Health Services, LLC | $162 | 3403% |
| Healthlink | $187 - $200 | 3929% |
| Multiplan | $187 - $200 | 3929% |
| Coventry Wc | $200 | 4202% |
Consumer Guidance & Cost Commentary
At Northeast Regional Medical Center in Kirksville, MO, the cash price for a blood test measuring potassium is $99, which is notably lower than the facility's gross charge of $250 and significantly below the state average of $89 for the same service. While the facility is a Proprietary Acute Care Hospital with a 2-star rating, patients with high-deductible plans might find the $99 cash rate more advantageous than the $89 median negotiated rate if their insurance allowed amount exceeds the cash price, though this scenario is less common given the close alignment between the two figures. Because commercial payers like UnitedHealthcare and Aetna often negotiate rates that can exceed cash prices, it is essential to verify your specific plan's allowed amount before proceeding with insurance billing to ensure you are not overpaying.
The facility accepts 25 different payers, ranging from Medicaid/KanCare with a range of $4 to $7 to Self Pay with a range of $60 to $137, highlighting the variability in costs based on insurance status. Although the facility does not report a specific median paid amount, the Medicare amount of $4.76 serves as a critical benchmark, indicating that commercial rates are substantially higher than the federal baseline. Consumers should be aware of balance billing risks if receiving out-of-network ancillary services, even at this in-network facility, and should request an itemized billing audit to identify any unbundled codes or services not rendered. Additionally, patients should inquire about prompt-pay discounts, as paying the full cash price upfront may yield further reductions or eliminate administrative fees associated with the insurance claims process.