Blood test, sodium
Facility: Nemaha Valley Community Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $17
- Cash Discount Price: $29
- vs. Medicare Baseline: 3.53x 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 353% of the Medicare baseline (a markup of 253%). 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 |
|---|---|---|
| Va Ccn - All Plans | $2 | 42% |
| Aetna | $14 - $27 | 291% |
| Humana | $14 | 291% |
| Celtic Comm Exch - All Plans | $15 | 312% |
| Partners Direct Health - All Plans | $17 | 353% |
| Multiplan - All Plans | $29 | 603% |
| Health Partners - All Plans | $30 | 624% |
| Midlands Choice - All Plans | $30 | 624% |
Consumer Guidance & Cost Commentary
For the blood test for sodium (CPT 84295) at Nemaha Valley Community Hospital in Seneca, KS, the facility's cash median price is $29.00, which is slightly lower than the state average of $32.00. While commercial insurance carriers negotiate lower rates to protect their members, these negotiated amounts often exceed the cash price due to administrative overhead and contract structures. For example, Aetna's negotiated rate is $14.00, while Multiplan's is $30.00, illustrating that in-network coverage does not guarantee the lowest possible cost. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the $29.00 cash rate is lower than the $22.00 median amount paid by insurers for this specific service.
To maximize savings, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling their visit, as hospitals often offer significant fee reductions for upfront payments that bypass costly insurance billing cycles. It is also important to review the facility's billing practices against federal protections; under the No Surprises Act, patients are protected from balance billing for out-of-network services at in-network facilities, though unexpected charges can still occur if ancillary services like lab tests are billed separately. Finally, consumers should compare the facility's pricing to the Medicare benchmark of $4.81, which serves as a scientifically validated baseline for the true cost of care, rather than relying on the hospital's inflated chargemaster list.