Blood test, sodium
Facility: Ellinwood District Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $33
- Cash Discount Price: $41
- vs. Medicare Baseline: 6.86x 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 686% of the Medicare baseline (a markup of 586%). 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 |
|---|---|---|
| Aetna | $33 | 686% |
| Blue Cross Blue Shield | $33 | 686% |
| Humana | $33 | 686% |
| Cigna | $33 | 686% |
| UnitedHealthcare | $33 | 686% |
Consumer Guidance & Cost Commentary
For this blood test for sodium at Ellinwood District Hospital, the negotiated rate is $33.00, which matches the median amount paid by all five major payers listed, including Aetna, Blue Cross Blue Shield, Humana, Cigna, and UnitedHealthcare. This negotiated rate is 6.9% higher than the Medicare benchmark of $4.81, indicating a markup typical of commercial insurance contracts. While the facility's cash price is listed at $41.00, which is higher than the negotiated rate, patients with high-deductible plans should be aware that paying cash upfront can sometimes be cheaper if their insurance negotiated rate exceeds the cash price; however, in this specific case, the insurance rate is lower. It is important to note that the facility is a Critical Access Hospital in Ellinwood, KS, and while the data does not provide specific county or state average comparisons for this code, the consistent $33.00 across all major payers suggests a standardized negotiated ceiling for this service in the region.
Patients should be cautious about balance billing, as the No Surprises Act generally protects against unexpected bills for out-of-network services at in-network facilities, though emergency physicians or lab services may occasionally trigger silent balance billing. If you are self-paying, you may be eligible for a prompt-pay discount, which is a fee reduction offered by hospitals for upfront payment that bypasses costly claims processing and administrative overhead. To secure this discount, you must request self-pay classification and prompt-pay rates before check-in and sign a waiver of insurance submission to prevent automatic claims that would void the cash agreement. Always demand a full itemized CPT-coded bill before negotiating or paying to ensure no errors