Blood test, sodium
Facility: Lane County Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $33
- Cash Discount Price: $33
- 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 | $30 - $31 | 624% |
| UnitedHealthcare | $30 - $33 | 624% |
| Healthy Blue Mcaid | $33 | 686% |
| Medicaid / KanCare | $33 - $36 | 686% |
| Healthy Blue Mcr Adv - All Other Plans | $33 | 686% |
| Wppa Providers-All Plans | $50 | 1040% |
Consumer Guidance & Cost Commentary
For the CPT code 84295 (Blood test, sodium) at Lane County Hospital in Dighton, KS, the facility's cash and negotiated rates are both $33.00, which aligns with the state average. This price is significantly higher than the Medicare benchmark of $4.81, reflecting the standard markup for commercial services. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients with high-deductible plans may find paying the cash price of $33.00 more cost-effective than using insurance, as the negotiated rates for payers like Aetna and UnitedHealthcare range from $30 to $36. To ensure you are receiving the best possible price, it is recommended to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
Understanding the billing structure is essential for avoiding unexpected costs. Although the facility provides a negotiated rate of $33.00, patients should be aware that commercial rates often include administrative overhead that can inflate the baseline price by 20% to 40% compared to the true cost of care. If you receive a bill that only shows broad categories like "Laboratory" without specific CPT codes, you should request an itemized audit to identify any unbundled charges or services not rendered, as over 80% of hospital bills contain errors. Furthermore, while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to verify your deductible status before scheduling, as you may be responsible for the full negotiated amount if your plan has not yet met its threshold