CMS Price Transparency Data

Blood test, potassium

Facility: St Anthony Community Hospital

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84132
  • Insurance Median: $35
  • Cash Discount Price: $76
  • vs. Medicare Baseline: 7.35x Medicare
The contracted insurance negotiated median rate for a Blood test, potassium at St Anthony Community Hospital is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $76. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 7.35x the Medicare baseline. Located in 15 Maple Avenue -19, Warwick, NY.
Cash / Self-Pay
$76

Average discount available for prompt cash payment at this facility.

Insurance Median
$35

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: $76 (1597%)
Insurance Median: $35 (735%)
Cash: $76 (1597% of Medicare)
Ins. Median: $35 (735% 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 735% of the Medicare baseline (a markup of 635%). 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
Tricare $5 105%
Mvp Gold (McR) $5 105%
Medicare (plans) $5 105%
Affinity By Molina McR $5 105%
Hamaspik (McR) $5 105%
Aetna $8 - $9 168%
Cigna $10 - $53 210%
Emblem Select Care (Exchange) $12 252%
Emblem Ghi/Hip PPO $14 294%
Geisinger Health Commercial/Exchange $16 336%
Magnacare Preferred $19 399%
Mvp Exchange $21 441%
Self-Pay - Cc 30% $23 483%
Blue Cross Blue Shield $35 - $217 735%
Cdphp $38 798%
Self-Pay - Cc 50% $38 798%
Oxford Exchange $38 798%
Self-Pay $39 819%
Mvp Hmo/Ppo $40 840%
UnitedHealthcare $53 1113%
Oxford Commercial $53 1113%
PHCS $57 1197%
Multiplan $57 1197%
Emblem Ghi/Hip Hmo/Epo/Pos $61 1282%
First Health $65 1366%
Mvp $666 - $785 13992%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15 Maple Avenue -19, Warwick, NY 10990
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals