Blood test, sodium
Facility: Mcpherson Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $29
- Cash Discount Price: $28
- vs. Medicare Baseline: 6.03x 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 603% of the Medicare baseline (a markup of 503%). 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 |
|---|---|---|
| Tricare | $4 | 83% |
| Va Ccn - All Plans | $5 | 104% |
| Blue Cross Blue Shield | $5 | 104% |
| UnitedHealthcare | $5 - $62 | 104% |
| Healthy Blue Mcr Adv | $5 | 104% |
| Wellcare Mcr Adv - All Plans | $5 | 104% |
| Humana | $5 | 104% |
| Ambetter / Centene | $6 | 125% |
| Wppa - All Plans | $20 - $43 | 416% |
| Central Plains - All Plans | $21 - $46 | 437% |
| Medical Associates - All Plans | $21 - $46 | 437% |
| Christian Health Aid - All Plans | $22 - $50 | 457% |
| Aetna | $23 - $62 | 478% |
| Multiplan - All Plans | $25 - $56 | 520% |
| Health Partners - All Plans | $27 - $59 | 561% |
| Cigna | $27 - $59 | 561% |
| First Health - All Plans | $27 - $59 | 561% |
| Medicaid / KanCare | $28 - $62 | 582% |
| Health Blue Mcaid - All Other Plans | $29 - $63 | 603% |
Consumer Guidance & Cost Commentary
For this blood test procedure at McPherson Hospital, the facility's cash price of $28.00 is lower than the state average of $31.00, making it a cost-effective option for patients without insurance or those with high-deductible plans. While most commercial payers negotiate rates ranging from $21.00 to $63.00, these amounts often exceed the cash price due to administrative overhead and contract structures. Patients should verify their specific plan's deductible status before scheduling, as paying the cash price upfront may result in immediate savings compared to the higher negotiated rates their insurer might apply. Additionally, asking the hospital about "self-pay" or "prompt-pay" discounts prior to check-in can further reduce the final bill, as these incentives are designed to bypass costly insurance billing cycles.
It is important to distinguish between the facility's gross charge of $38.00 and the actual amounts billed to patients, as the latter varies significantly based on insurance contracts. The facility's negotiated rate of $29.00 sits slightly above the cash price but remains below the gross charge, illustrating how commercial rates are structured. For patients concerned about balance billing or unexpected charges, the No Surprises Act provides federal protections against out-of-network billing for emergency care and non-emergency services at in-network facilities. If a patient receives a bill that appears to include charges for services not rendered or unbundled components, they should request a formal itemized audit to identify errors, as over 80% of hospital bills contain discrepancies that can be resolved through written dispute with the billing supervisor.