Blood test, sodium
Facility: Saint John Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $5
- Cash Discount Price: $4
- vs. Medicare Baseline: 1.04x 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 |
|---|---|---|
| Medicaid / KanCare | $4 | 83% |
| UnitedHealthcare | $4 - $7 | 83% |
| Healthy Blue | $4 - $5 | 83% |
| Celtic | $4 - $31 | 83% |
| Aetna | $5 - $8 | 104% |
| Medicare (plans) | $5 | 104% |
| Kansas Superior Select | $5 | 104% |
| Midland Care Connection | $5 | 104% |
| Cigna | $5 | 104% |
| Blue Cross Blue Shield | $5 - $10 | 104% |
| Tricare | $5 | 104% |
| Naphcare | $7 | 146% |
| Employer Direct Healthcare | $7 | 146% |
| Centurion | $7 | 146% |
| Corizon | $7 | 146% |
| Well Path | $7 | 146% |
| Comp Alliance Workers Comp | $10 | 208% |
| Worker Compensation | $11 | 229% |
| Oha Networks | $11 | 229% |
Consumer Guidance & Cost Commentary
For the blood test for sodium (CPT 84295) at Saint John Hospital in Leavenworth, KS, the cash median price is $4.00, which is significantly lower than the facility's gross charge of $90.00. While the hospital's negotiated rates with major payers like UnitedHealthcare and Aetna range from $4 to $8, these amounts are still higher than the cash price. This price difference highlights the potential savings of paying out-of-pocket, as commercial insurance contracts often include administrative overhead that inflates the final bill. Patients with high-deductible plans may find it financially advantageous to pay the $4.00 cash rate directly, provided they confirm with the hospital that their specific insurance plan does not require a higher allowed amount for this service.
To maximize savings, patients should proactively request a "prompt-pay" discount before scheduling their visit, as hospitals often offer an additional reduction for upfront payments that bypasses the costly insurance claims process. It is also important to avoid balance billing by ensuring the facility is in-network, though the No Surprises Act protects patients from unexpected bills for emergency care or out-of-network ancillary services at in-network facilities. Finally, if a large bill is received, consumers should request a detailed, itemized audit rather than accepting a summary statement, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Comparing the facility's rates to the Medicare benchmark of $4.81 provides a clear baseline, showing that the cash price is nearly half the federal standard, while the negotiated rates reflect the complex dynamics of commercial insurance contracts.