Blood test, sodium
Facility: Stormont Vail Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $8
- Cash Discount Price: Unavailable
- 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 |
|---|---|---|
| Blue Cross Blue Shield | $4 - $10 | 83% |
| Ambetter / Centene | $4 | 83% |
| UnitedHealthcare | $4 | 83% |
Consumer Guidance & Cost Commentary
For the CPT code 84295, representing a blood test for sodium at Stormont Vail Hospital in Topeka, KS, the median amount paid by insurance is $4,420.00, which is 1.7 times the Medicare benchmark of $4.81. This negotiated rate is significantly higher than the facility's cash median, which is not available in this dataset. While commercial insurance contracts often result in higher out-of-pocket costs for patients due to administrative overhead and claim processing fees, patients with high-deductible plans may find that paying the cash price directly is more cost-effective than relying on insurance, especially if the negotiated rate exceeds the cash price. It is important to note that while the facility is a voluntary non-profit acute care hospital, the specific cash rate for this service is not listed, so patients should verify current self-pay or prompt-pay discounts directly with the hospital before scheduling.
This service is covered by three payers in the region, including Blue Cross Blue Shield, Ambetter/Centene, and UnitedHealthcare, with negotiated rates ranging from a low of 4 to a high of 10 across their plans. However, the data does not provide a specific comparison to the Kansas state or county average for this procedure, so the facility's pricing cannot be directly benchmarked against regional norms in this report. Patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, but they should still request an itemized bill to ensure no unbundled charges or services not rendered are included. If a patient receives a large bill after insurance submission, they should dispute any discrepancies in writing rather