Blood test, sodium
Facility: Ashland Health Center
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $16
- Cash Discount Price: $13
- vs. Medicare Baseline: 3.33x 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 333% of the Medicare baseline (a markup of 233%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $5 | 104% |
| Compalliance-All Plans | $13 | 270% |
| Health Partners Of Kansas-All Plans | $14 | 291% |
| Multiplan-All Plans | $16 | 333% |
| Aetna | $16 | 333% |
| UnitedHealthcare | $16 | 333% |
| Medica Mcare - All Plans | $16 | 333% |
| Medicaid / KanCare | $16 | 333% |
| Healthy Blue Mcr Adv - All Other Plans | $16 | 333% |
| Medicare (plans) | $16 | 333% |
| Health Choice-All Plans | $16 | 333% |
| Providers Care (Wppa)-All Plans | $24 | 499% |
Consumer Guidance & Cost Commentary
For the CPT code 84295 (Blood test, sodium), Ashland Health Center in Ashland, KS, lists a gross charge of $16.00. This amount aligns with the median negotiated rate of $16.00 across 12 payers, including Blue Cross Blue Shield, UnitedHealthcare, and Medicaid/KanCare. The facility's cash median price is $13.00, which is lower than the negotiated rates. While the state or county average is not provided in this data, patients should note that paying cash upfront can sometimes be more cost-effective than using insurance, particularly if their plan has a high deductible or if the insurance negotiated rate exceeds the cash price. It is advisable to ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling the test, as these incentives can further reduce the final cost.
The Medicare benchmark for this service is $4.81, which serves as a baseline for evaluating the facility's pricing. The gross charge of $16.00 is 3.3 times the Medicare amount, reflecting the typical markup found in commercial billing structures where administrative costs and contract dynamics influence the final price. Since this is a Critical Access Hospital, the pricing may be subject to specific federal regulations, but patients should still verify their specific plan details. If you receive a bill that includes charges for services not rendered or unbundled codes, you have the right to request an itemized billing audit to ensure accuracy. Always check your deductible status before proceeding, as using insurance for shoppable tests may result in higher out-of-pocket costs if the deductible has not been met.