Blood test, sodium
Facility: Lmh
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $5
- Cash Discount Price: $30
- vs. Medicare Baseline: 1.04x 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 - $78 | 83% |
| UnitedHealthcare | $4 - $46 | 83% |
| Allwell | $5 | 104% |
| Cigna | $5 - $80 | 104% |
| Humana | $5 | 104% |
| Haskell Indian Health Services | $5 | 104% |
| Medicare (plans) | $5 | 104% |
| Aetna | $5 - $100 | 104% |
| Ambetter / Centene | $7 | 146% |
| Non Contracted | $96 | 1996% |
| First Health | $112 | 2328% |
Consumer Guidance & Cost Commentary
For this blood test for sodium at Lmh in Lawrence, KS, the cash price of $30.00 is significantly lower than the facility's gross charge of $120.00 and the Medicare benchmark of $4.81. While the facility's negotiated rates for in-network plans range from $4 to $112 depending on the carrier, the cash price offers a substantial discount for those without insurance or with high-deductible plans. Patients should verify if their specific plan has a deductible that exceeds the cash price, as paying out-of-pocket upfront can sometimes result in lower total costs than the insurance allowed amount, which varies widely across the 11 payers listed.
To ensure you are not overcharged, it is critical to request an itemized bill before paying, as summary bills often hide errors or unbundled charges. If you receive a balance bill from an out-of-network provider, such as the non-contracted rate of $96, you may be protected under the No Surprises Act, which bans balance billing for emergency care and non-emergency services at in-network facilities. Additionally, ask the billing department about prompt-pay discounts, which can reduce the final amount by 20% to 50% if settled in full within 30 days, effectively bypassing the administrative costs associated with insurance claims processing.