Blood test, sodium
Facility: Pratt Regional Medical Center
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $30
- Cash Discount Price: $24
- vs. Medicare Baseline: 6.24x 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 624% of the Medicare baseline (a markup of 524%). 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 |
|---|---|---|
| Christian Health Aid | $26 | 541% |
| UnitedHealthcare | $28 - $35 | 582% |
| Health Partners Of Kansas | $29 | 603% |
| Aetna | $31 | 644% |
| Choicecare | $34 | 707% |
Consumer Guidance & Cost Commentary
For the blood test for sodium at Pratt Regional Medical Center, the cash price is $24.00, which is $9.20 lower than the facility's gross chargemaster rate of $34.00. While in-network insurance plans like UnitedHealthcare and Health Partners Of Kansas negotiate rates ranging from $28.00 to $35.00, these amounts are higher than the cash price. This difference highlights that paying out-of-pocket can sometimes be more cost-effective for patients with high-deductible plans or those who have already met their deductible, as the insurance negotiated rate often exceeds the cash price. To maximize savings, patients should verify their specific plan's allowed amount and ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill.
The facility's pricing reflects a 6.2% markup compared to the Medicare benchmark rate of $4.81, illustrating how commercial rates can differ significantly from federal cost baselines. Although the data does not provide specific state or county average comparisons for this CPT code, it is important to understand that commercial negotiated rates often include administrative overhead that pushes them above the true cost of care. If you receive a bill that appears to include balance billing for out-of-network services, such as specific lab components, you have the right to dispute the charge under the No Surprises Act. Always request a full, itemized bill before paying to ensure no unbundled codes or services not rendered are included, and consider sending a formal written audit dispute if errors are found.