Blood test, sodium
Facility: Mercy Hospital Pittsburg, Inc
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $8
- Cash Discount Price: $27
- vs. Medicare Baseline: 1.66x 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 $4.81 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.
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 |
|---|---|---|
| Humana | $4 - $5 | 83% |
| Aetna | $4 - $36 | 83% |
| UnitedHealthcare | $4 - $28 | 83% |
| Medicaid / KanCare | $4 - $8 | 83% |
| Blue Cross Blue Shield | $4 - $12 | 83% |
| Halo Hcr Inc Hospice [20432] | $5 | 104% |
| American Health Advantage Of Ks Mcr Contracted [320508] | $5 | 104% |
| Medica Contracted [320239] | $5 | 104% |
| Halo Hcr Inc Hospice Contracted [320432] | $5 | 104% |
| Dept Of Veteran Affairs Contracted [320106] | $5 | 104% |
| Elara Caring Aspire Hospice [20433] | $5 | 104% |
| Mercy Hospice Okc [20252] | $5 | 104% |
| Cross Timbers Hospice [20098] | $5 | 104% |
| Pace Of The Ozarks Contracted [320518] | $5 | 104% |
| Medicare (plans) | $5 | 104% |
| Tricare | $5 | 104% |
| Kindful Hospice Contracted [320434] | $5 | 104% |
| Kindful Hospice [20434] | $5 | 104% |
| Health Choice Contracted [320166] | $6 | 125% |
| Ambetter / Centene | $8 | 166% |
| Home State Health Plan Contracted [320187] | $8 | 166% |
| Providrs Care Network Contracted [320484] | $9 | 187% |
| Cigna | $26 - $27 | 541% |
| United Medical Resources Contracted [320454] | $28 | 582% |
| American Healthcare Alliance Contracted [320020] | $34 | 707% |
| Reflect Health Contracted [320492] | $34 | 707% |
| Edison Health Solutions Contracted [320502] | $34 | 707% |
| Workers Comp [20426] | $34 | 707% |
| Imagine 360 Contracted [320494] | $34 | 707% |
| Mercy Benefit Admin Contracted [320251] | $34 | 707% |
| Auxiant Contracted [320462] | $34 | 707% |
| Healthlink Contracted [320179] | $34 | 707% |
| Aither Health Contracted [320449] | $34 | 707% |
| Yuzu Health Contracted [320521] | $34 | 707% |
| Ebms Contracted [320493] | $34 | 707% |
| First Health Contracted [320128] | $36 | 748% |
Consumer Guidance & Cost Commentary
For this blood test for sodium (CPT 84295) at Mercy Hospital Pittsburg, the cash price is $27.00, which is significantly lower than the facility's gross charge of $42.00. While the facility's negotiated rates with major payers like Humana and Aetna range from $4.00 to $36.00 depending on the specific plan, the cash price offers a clear baseline for self-pay patients. It is important to note that for individuals with high-deductible plans, paying the cash price of $27.00 upfront may be more cost-effective than relying on insurance, as the negotiated rates for many commercial plans can exceed this amount. Patients should verify their specific plan's allowed amount before scheduling, as some in-network contracts may result in higher out-of-pocket costs than the cash rate.
To ensure you are receiving the most accurate pricing, it is recommended to request an itemized bill that breaks down the exact CPT code and unit costs, as summary bills often obscure individual charges. Additionally, ask the billing department about prompt-pay discounts, which can reduce the final amount by 20% to 50% if paid in full within a short window, bypassing the administrative costs associated with insurance claims. While the facility's rating is 3 out of 5, the pricing data indicates that the cash rate is competitive, and patients should avoid accepting verbal dispute settlements; instead, any billing errors should be formally disputed in writing to protect against double-billing or unbundled charges.