Blood test, sodium
Facility: Stafford County Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $22
- Cash Discount Price: $23
- vs. Medicare Baseline: 4.57x 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 457% of the Medicare baseline (a markup of 357%). 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 |
|---|---|---|
| UnitedHealthcare | $1 | 21% |
| Va Ccn-All Plans | $1 | 21% |
| Health Partners-All Plans | $22 | 457% |
| Humana | $23 | 478% |
| Medica Mcr- All Plans | $23 | 478% |
Consumer Guidance & Cost Commentary
For the blood test for sodium (CPT code 84295) at Stafford County Hospital in Stafford, KS, the cash and median paid rates are both $23.00, which matches the facility's gross charge. This rate is significantly higher than the state average, reflecting a markup of 4.6 times the Medicare benchmark of $4.81. While commercial negotiated rates for this service vary across payers, with Humana and Medica Mcr- All Plans showing a range of $23.00 and UnitedHealthcare and Va Ccn-All Plans at $1.00, patients should be aware that cash payments may sometimes be more cost-effective than using insurance if the negotiated rate exceeds the cash price. Given that this facility is a Critical Access Hospital owned by the local government, patients are encouraged to verify "self-pay" or "prompt-pay" discounts directly with the hospital before scheduling, as these upfront incentives can reduce administrative costs and improve cash flow for the provider.
To ensure you are not overcharged, it is important to request an itemized billing audit rather than accepting a summary bill, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Since the Medicare rate for this procedure is $4.81, any commercial rate should ideally fall between 120% and 150% of this benchmark for fair pricing; however, commercial contracts often include administrative overhead that inflates the baseline price. If you receive a bill, dispute any errors in writing to the billing supervisor to avoid verbal misunderstandings, and be cautious of automatic claims submission that might void a cash discount agreement. Always check your deductible status