Blood test, sodium
Facility: Mercy Hospital Columbus
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $64
- Cash Discount Price: $57
- vs. Medicare Baseline: 13.31x 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 1331% of the Medicare baseline (a markup of 1231%). 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 | $4 - $64 | 83% |
| Humana | $4 - $84 | 83% |
| Medicaid / KanCare | $4 - $64 | 83% |
| UnitedHealthcare | $4 - $73 | 83% |
| Medicare (plans) | $5 - $66 | 104% |
| Insurance System Inc Contracted [320465] | $38 | 790% |
| Health Systems Inc Contracted [320174] | $38 | 790% |
| Administrative Payor Contracted [320005] | $40 | 832% |
| Ambetter / Centene | $64 | 1331% |
| Provider Partners Health Plans Contracted [320450] | $64 | 1331% |
| Novasys Contracted [320285] | $64 | 1331% |
| Elara Caring Aspire Hospice [20433] | $64 | 1331% |
| Indian Health Service Contracted [320198] | $64 | 1331% |
| Halo Hcr Inc Hospice Contracted [320432] | $64 | 1331% |
| Dept Of Veteran Affairs Contracted [320106] | $64 | 1331% |
| Cherokee Nation Health Serv Contracted [320066] | $64 | 1331% |
| Mercy Hospice Okc [20252] | $64 | 1331% |
| Cigna | $64 | 1331% |
| Kindful Hospice [20434] | $64 | 1331% |
| Medical Associates Health Contracted [320444] | $64 | 1331% |
| Qual Choice Contracted [320325] | $64 | 1331% |
| Halo Hcr Inc Hospice [20432] | $64 | 1331% |
| Tricare | $64 | 1331% |
| Centurion Of Missouri [20459] | $64 | 1331% |
| Globalhealth Contracted [320145] | $64 | 1331% |
| Mercy Mgd Behavioral Health Contracted [320259] | $64 | 1331% |
| Cross Timbers Hospice [20098] | $64 | 1331% |
| Pace Of The Ozarks Contracted [320518] | $64 | 1331% |
| Kindful Hospice Contracted [320434] | $64 | 1331% |
| Aetna | $64 - $79 | 1331% |
| Home State Health Plan Contracted [320187] | $64 | 1331% |
| Healthscope Contracted [320182] | $68 | 1414% |
| Workers Comp [20426] | $70 - $75 | 1455% |
| United Medical Resources Contracted [320454] | $73 - $84 | 1518% |
| Federal Medical Center Contracted [320127] | $79 | 1642% |
| American Healthcare Alliance Contracted [320020] | $79 | 1642% |
| Mercy Benefit Admin Contracted [320251] | $79 - $84 | 1642% |
| First Health Contracted [320128] | $79 | 1642% |
| Preferred Health Plan Contracted [320522] | $79 | 1642% |
| Medica Contracted [320239] | $79 | 1642% |
| Usa Managed Care Org Contracted [320429] | $79 | 1642% |
| Healthlink Contracted [320179] | $79 - $84 | 1642% |
| Ebms Contracted [320493] | $84 | 1746% |
| Yuzu Health Contracted [320521] | $84 | 1746% |
| Private Health Care Systems Contracted [320320] | $84 | 1746% |
| Point C Contracted [320238] | $84 | 1746% |
| Edison Health Solutions Contracted [320502] | $84 | 1746% |
| 90 Degree Benefits Contracted [320436] | $84 | 1746% |
| Imagine 360 Contracted [320494] | $84 | 1746% |
| Ppo Plus Contracted [320310] | $84 | 1746% |
| Benefit Management Contracted [320052] | $84 | 1746% |
| Reflect Health Contracted [320492] | $84 | 1746% |
| Aither Health Contracted [320449] | $84 | 1746% |
| Show-Me Health Administrators Contracted [320483] | $84 | 1746% |
| Auxiant Contracted [320462] | $84 | 1746% |
Consumer Guidance & Cost Commentary
For the CPT code 84295 (Blood test, sodium), Mercy Hospital Columbus lists a cash median price of $57.00, which is lower than the facility's gross charge of $88.00. While many commercial payers negotiate rates ranging from $4 to $84, the cash price can be a more economical option for patients with high-deductible plans or those without insurance, as it avoids the administrative markup inherent in negotiated rates. Patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed if the bill is settled in full upfront.
The facility's cash rate of $57.00 is notably lower than the Medicare benchmark of $4.81 when adjusted for the facility's specific cost structure, though the direct comparison shows the cash price is significantly higher than the Medicare amount of $4.81. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still request an itemized bill to verify all charges. If a patient receives a summary bill, they should demand a detailed line-by-line statement to identify any unbundled codes or services not rendered, ensuring they are not paying for unnecessary items.