Blood test, sodium
Facility: Kansas Medical Center Llc
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $5
- Cash Discount Price: $25
- 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 |
|---|---|---|
| United | $2 | 42% |
| Indian Health | $4 | 83% |
| Medicaid / KanCare | $4 | 83% |
| Medadv_Wellcare | $5 | 104% |
| Ambetter / Centene | $5 | 104% |
| Humana | $5 | 104% |
| Blue Cross Blue Shield | $5 - $11 | 104% |
| Three_Rivers | $10 | 208% |
| Wppa | $13 - $21 | 270% |
| Aetna | $15 | 312% |
Consumer Guidance & Cost Commentary
For this blood test for sodium at Kansas Medical Center Llc in Andover, the cash median price is $25.00, which is significantly lower than the facility's negotiated rates of $5.00 and the median paid amount of $46.00. While the facility's negotiated rate of $5.00 is lower than the gross charge of $42.00, patients should be aware that insurance plans often pay amounts higher than the cash price due to administrative costs and contract structures. If you have a high-deductible plan or have not yet met your deductible, paying the cash price of $25.00 upfront could result in immediate savings compared to the $46.00 average paid by insurers. To maximize these savings, we recommend asking the billing department about "self-pay" or "prompt-pay" discounts before scheduling your visit, as paying in full within a short window can sometimes reduce the total amount owed.
The Medicare benchmark for this service is $4.81, which serves as a baseline for evaluating the facility's pricing markup. The facility's cash rate of $25.00 is approximately five times the Medicare amount, while the negotiated rate of $5.00 is roughly 104% of the Medicare rate, falling within the range often considered fair pricing. It is important to note that the facility is a Proprietary Acute Care Hospital in Kansas, and while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, unexpected charges can still occur for ancillary services. We advise requesting a detailed, itemized bill to review specific CPT codes and ensure no unbundled charges or