Blood test, sodium
Facility: Wesley Medical Center
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $7
- Cash Discount Price: $270
- vs. Medicare Baseline: 1.46x 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 |
|---|---|---|
| United | $2 - $237 | 42% |
| Medical Associates Health Plan | $2 - $100 | 42% |
| Wppa | $2 - $92 | 42% |
| Ambetter / Centene | $2 - $95 | 42% |
| Preferred Health Choices | $2 - $100 | 42% |
| Health Partners Of Kansas | $2 - $264 | 42% |
| Spirit Aerosystems | $4 - $169 | 83% |
| Amerigroup | $4 | 83% |
| Medicaid / KanCare | $4 | 83% |
| UnitedHealthcare | $4 | 83% |
| Aetna | $4 - $188 | 83% |
| Humana | $5 | 104% |
| Coventry Health Care | $5 | 104% |
| Triwest Health Alliance | $5 | 104% |
| Devoted Health | $5 | 104% |
| First Health | $6 - $243 | 125% |
| Correct Care Solutions | $7 | 146% |
| Triwest Healthcare Alliance | $8 - $343 | 166% |
| Multiplan | $9 - $474 | 187% |
| Usa Managed Care | $11 - $448 | 229% |
| Blue Cross Blue Shield | $13 | 270% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Wesley Medical Center in Wichita, KS, the cash price is $270.00, which matches the facility's cash median. While the facility's negotiated rates for various payers range from $2 to $474, patients with high-deductible plans may find paying cash upfront more cost-effective if their insurance negotiated rate exceeds the cash price. It is important to note that commercial insurance contracts often include administrative overhead that can inflate the baseline price by 20% to 40%, meaning the negotiated rate is frequently higher than the cash price. To maximize savings, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the total bill by 20% to 50%.
The facility's pricing is evaluated against the Medicare benchmark, which serves as a scientifically validated cost baseline. The Medicare amount for this service is $4.81, and the facility's cash rate of $270.00 represents a 1.5x markup relative to this federal standard. This comparison highlights that commercial rates often differ significantly from the true cost of care delivery. Additionally, while the facility is in-network for many plans, patients should be aware of the No Surprises Act protections regarding balance billing for out-of-network services at in-network facilities. If a patient receives a bill that appears to include unexpected charges, they should request a formal itemized audit to verify that all services rendered are accurately coded and that no unbundled charges or services not delivered have been included.