Blood test, sodium
Facility: Hamilton County Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $46
- Cash Discount Price: $51
- vs. Medicare Baseline: 9.56x 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 956% of the Medicare baseline (a markup of 856%). 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 - $10 | 104% |
| First Health Coventry - All Plans | $43 | 894% |
| Cigna | $48 | 998% |
| UnitedHealthcare | $48 | 998% |
| Va Ccn - All Plans | $51 | 1060% |
| Aetna | $86 | 1788% |
Consumer Guidance & Cost Commentary
For the blood test for sodium (CPT code 84295) at Hamilton County Hospital in Syracuse, KS, the cash price is $51.00, which matches the facility's negotiated rate and the median paid amount. This cash price is significantly higher than the Medicare benchmark of $4.81, a difference of 9.6 times the Medicare rate. While commercial insurance plans like Blue Cross Blue Shield, First Health Coventry, Cigna, UnitedHealthcare, and Aetna have negotiated rates ranging from $46.00 to $86.00, these amounts often exceed the cash price. For patients with high-deductible plans, paying the cash price of $51.00 upfront may be more cost-effective than relying on insurance, as the insurer's allowed amount could result in a higher out-of-pocket cost once deductibles are applied.
Patients should be aware that hospitals often issue summary bills that obscure individual charges, making it difficult to identify errors or unbundled services. To ensure you are paying the correct amount, request a full itemized bill showing specific CPT codes before finalizing payment. Additionally, ask the billing department about "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if you pay in full within a short window, bypassing the administrative costs associated with insurance claims. Since this facility is a Critical Access Hospital owned by the local government, verify that your specific plan is in-network to avoid potential balance billing, though the No Surprises Act protects you from surprise bills for out-of-network services at in-network facilities.