Blood test, sodium
Facility: Kansas City Orthopaedic Institute
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $11
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 2.29x 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 229% of the Medicare baseline (a markup of 129%). 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 |
|---|---|---|
| UnitedHealthcare | $5 - $13 | 104% |
| Cigna | $5 - $11 | 104% |
| Aetna | $5 | 104% |
| Blue Cross Blue Shield | $9 - $15 | 187% |
| Medica | $12 - $13 | 249% |
Consumer Guidance & Cost Commentary
For the blood test for sodium (CPT code 84295) at Kansas City Orthopaedic Institute in Leawood, KS, the facility's negotiated rates range from $5 to $15 depending on your specific insurance plan, with UnitedHealthcare and Cigna plans falling between $5 and $13. While the facility's median negotiated rate of $11.00 is significantly higher than the Medicare benchmark of $4.81, it is important to note that cash payments are not listed in this dataset. In many cases, patients with high-deductible plans may find that paying cash directly is more cost-effective than using insurance, as the insurance negotiated rate often exceeds the cash price. However, since cash rates were not provided, we recommend contacting the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can sometimes reduce the final bill by 20% to 50% if paid upfront.
This service is provided by an Acute Care Hospital owned by physicians, and while the data does not include state or county average comparisons for this specific code, the disparity between the Medicare rate and commercial negotiated rates highlights the importance of understanding your plan's allowed amount. Under the No Surprises Act, you are protected from balance billing for out-of-network services at in-network facilities, but you should still verify your network status before scheduling to avoid unexpected costs. If you receive an itemized bill, review it carefully to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be disputed in writing. Always confirm your deductible status before proceeding, as paying the full negotiated rate may not be necessary if