Blood test, sodium
Facility: Kansas Spine & Specialty Hospital, Llc
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $5
- Cash Discount Price: $35
- 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 |
|---|---|---|
| Providrs Care Network | $5 | 104% |
| Humana | $5 | 104% |
| United Mine Workers Of America | $5 | 104% |
| UnitedHealthcare | $5 - $6 | 104% |
| Aetna | $5 - $6 | 104% |
| Blue Cross Blue Shield | $5 | 104% |
| Lantern Specialty Care | $8 | 166% |
Consumer Guidance & Cost Commentary
For this blood test for sodium at Kansas Spine & Specialty Hospital, the cash median price is $35.00, which is significantly lower than the facility's gross charge of $54.00. While the facility is owned by a physician and located in Wichita, KS, the data does not provide specific county or state average benchmarks for comparison. However, the cash rate is notably lower than the Medicare amount of $4.81, suggesting that for patients with high-deductible plans, paying out-of-pocket may result in substantial savings compared to insurance reimbursement. Patients should verify their specific plan details, as commercial negotiated rates can sometimes exceed cash prices due to administrative costs and contract structures.
Insurance payers such as UnitedHealthcare, Aetna, and Blue Cross Blue Shield have negotiated rates for this service, though the data indicates these amounts are not available in the current report. It is important to note that even if a facility is in-network, patients may still face balance billing if certain ancillary services are out-of-network, though the No Surprises Act protects against this for emergency and non-emergency care at in-network facilities. To minimize costs, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as paying in full upfront can often reduce the final bill by 20% to 50%. Additionally, if a large bill is received, patients should request a detailed, itemized audit to ensure no errors or unbundled charges are included before making any payment.