Blood test, sodium
Facility: Overland Park Reg Med Ctr
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $36
- Cash Discount Price: $206
- vs. Medicare Baseline: 7.48x 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 748% of the Medicare baseline (a markup of 648%). 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 |
|---|---|---|
| Cigna | $2 - $5 | 42% |
| United | $4 - $97 | 83% |
| Healthyblue | $4 | 83% |
| Medicaid / KanCare | $4 | 83% |
| Unicare | $4 | 83% |
| Aetna | $4 - $110 | 83% |
| Amerigroup | $4 | 83% |
| Celtic | $5 | 104% |
| Coventry | $5 - $87 | 104% |
| Blue Cross Blue Shield | $5 - $93 | 104% |
| Triwest Health Alliance | $5 | 104% |
| Pyramid Life | $5 | 104% |
| Devoted Health | $5 | 104% |
| Home State Health Plan | $5 | 104% |
| Wellcare | $5 | 104% |
| Humana | $5 - $12 | 104% |
| Oscar | $7 | 146% |
| Multiplan | $9 - $160 | 187% |
| Corvel Corporation | $10 - $141 | 208% |
| Oha Network | $11 - $108 | 229% |
| Ambetter / Centene | $36 - $40 | 748% |
| Nhc Advantage | $37 - $41 | 769% |
| Wppa Providrs Care Network | $39 - $43 | 811% |
| Universal Healthcare | $68 - $76 | 1414% |
| Coventry Kc Mo | $80 - $89 | 1663% |
| College Park Family Care Center | $84 - $93 | 1746% |
| Cco, Inc. | $147 - $162 | 3056% |
| Focus Healthcare Mgmt, Inc | $147 - $162 | 3056% |
Consumer Guidance & Cost Commentary
For the blood test for sodium (CPT 84295) at Overland Park Reg Med Ctr in Kansas, the cash price is $206.00, which matches the facility's median paid amount. This cash rate is significantly lower than the facility's negotiated rates, which range from $36.00 to $162.00 depending on the insurance plan. While many commercial payers have negotiated rates that appear lower than the cash price on paper, patients with high-deductible plans may find the cash price more affordable if their insurance allowed amount exceeds $206.00. It is important to note that the facility's cash rate is 7.5 times the Medicare benchmark of $4.81, and while the negotiated rates vary widely across the 28 participating payers, the cash option provides a predictable baseline cost.
Patients should be aware that hospitals often offer prompt-pay discounts, which can reduce the bill by 20% to 50% for upfront payment within 30 days, effectively lowering the cost below the listed cash price. To secure this discount, patients must request self-pay classification and a waiver of insurance submission before check-in to prevent automatic claims processing. Additionally, under the No Surprises Act, patients are protected from balance billing for out-of-network services at in-network facilities, though they should still request an itemized bill to verify all charges. For this specific service, the cash price of $206.00 serves as a clear reference point, and patients are encouraged to confirm any additional self-pay or prompt-pay reductions directly with the billing department prior to scheduling.