Blood test, sodium
Facility: Grisell Memorial Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $15
- Cash Discount Price: $25
- vs. Medicare Baseline: 3.12x 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 312% of the Medicare baseline (a markup of 212%). 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 | $1 - $20 | 21% |
| Blue Cross Blue Shield | $10 | 208% |
| Medicaid / KanCare | $26 | 541% |
| Humana | $26 | 541% |
Consumer Guidance & Cost Commentary
For this blood test for sodium at Grisell Memorial Hospital in Ransom, KS, the cash price is $25.00, which is slightly lower than the facility's negotiated rates of $15.00 to $26.00 across four payers including UnitedHealthcare, Blue Cross Blue Shield, Medicaid/KanCare, and Humana. While the cash price is competitive, patients should be aware that commercial insurance often negotiates rates higher than cash due to administrative costs and contract structures; however, if a patient has a high deductible or out-of-pocket maximum, paying the $25.00 cash price upfront may result in lower total out-of-pocket costs compared to having insurance process the claim, especially if the allowed amount exceeds the cash rate. Since this facility is a Critical Access Hospital owned by a Government Hospital District, patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as these can further reduce the final bill.
The facility's Medicare benchmark for this service is $4.81, which serves as a cost-based baseline rather than a market price. The cash rate of $25.00 is significantly higher than the Medicare amount of $4.81, reflecting the commercial markup typical in the healthcare system where negotiated rates often range from 200% to 300% of the Medicare rate. If a patient receives this service out-of-network, they could face balance billing for the difference between the facility's chargemaster and the insurance allowed amount, though the No Surprises Act protects against this for emergency care and non-emergency services at in-network facilities. To avoid unexpected charges, patients should request a full itemized bill to