Blood test, sodium
Facility: St. Catherine Hospital - Garden City
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $17
- Cash Discount Price: $28
- vs. Medicare Baseline: 3.53x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 353% of the Medicare baseline (a markup of 253%). 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 |
|---|---|---|
| Kansas Health | $5 | 104% |
| Aetna | $5 - $37 | 104% |
| Humana | $5 | 104% |
| Kaiser | $5 - $26 | 104% |
| Cigna | $5 - $6 | 104% |
| Devoted Health | $5 | 104% |
| Innovage | $5 | 104% |
| Blue Cross Blue Shield | $5 - $17 | 104% |
| Medicare (plans) | $5 | 104% |
| UnitedHealthcare | $5 - $27 | 104% |
| Centura Employee Plan | $6 | 125% |
| United Colorado Doctor'S Plan | $7 | 146% |
| Direct To Employer | $8 - $38 | 166% |
| Denver Health | $23 | 478% |
| Wpaa | $30 | 624% |
| Christian Health Aid | $35 | 728% |
| Peak Health | $37 | 769% |
| Multiplan | $39 - $81 | 811% |
| Health Partners Of Kansas | $42 | 873% |
Consumer Guidance & Cost Commentary
For CPT code 84295, a blood test for sodium, St. Catherine Hospital in Garden City, KS, lists a gross charge of $69.00, with a cash median of $28.00 and a median negotiated rate of $17.00. This facility is a voluntary non-profit church-owned acute care hospital located at 401 East Spruce. While the cash price of $28.00 is significantly lower than the gross charge, it remains higher than the Medicare benchmark of $4.81, which serves as the objective baseline for true cost. Patients should note that commercial negotiated rates often include administrative overhead and can exceed cash prices; therefore, individuals with high-deductible plans might find paying cash directly more cost-effective than relying on insurance, provided they verify their specific plan's allowed amount.
When considering payment options, it is crucial to ask about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can reduce the final bill by 20% to 50% by bypassing costly claims processing. Although this specific code does not show a direct comparison to state or county averages in the provided data, understanding that Medicare rates represent the "true cost" helps patients avoid being misled by inflated chargemaster lists. If you receive a bill, always request a full itemized statement to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit dispute rather than accepting a summary invoice.