Blood test, sodium
Facility: F W Huston Medical Center
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $29
- Cash Discount Price: $30
- vs. Medicare Baseline: 6.03x 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 603% of the Medicare baseline (a markup of 503%). 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 | $10 | 208% |
| Aetna | $28 | 582% |
| Humana | $30 | 624% |
| Cigna | $32 | 665% |
Consumer Guidance & Cost Commentary
For the blood test for sodium (CPT 84295) at F W Huston Medical Center in Winchester, KS, the facility's cash and median negotiated rates are both $30.00, which is significantly higher than the Medicare benchmark of $4.81. This represents a markup of 600% over the federal baseline, indicating that the commercial rates are well above the "fair pricing" range of 120% to 150% of Medicare. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should note that the cash price of $30.00 is already lower than the gross charge of $38.00. For individuals with high-deductible plans, paying the cash price directly may be more cost-effective than relying on insurance, as the negotiated rate of $30.00 could still exceed the patient's out-of-pocket maximum if their deductible is not met.
It is important to verify if the facility offers additional discounts before scheduling, as hospitals often provide prompt-pay reductions for upfront cash payments to bypass administrative claim processing costs. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still request a detailed itemized bill to ensure no unbundled codes or services not rendered are included. Given that over 80% of hospital bills contain errors, consumers are encouraged to review their statement line-by-line rather than accepting a summary invoice. Always confirm the specific self-pay or prompt-pay rates with the billing department prior to check-in to ensure you are receiving the lowest possible price for this service.