Blood test, sodium
Facility: Ellsworth County Medical Center
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $37
- Cash Discount Price: $42
- vs. Medicare Baseline: 7.69x 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 769% of the Medicare baseline (a markup of 669%). 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% |
| Humana | $20 - $39 | 416% |
| Va Ccn-All Plans | $20 | 416% |
| Triwest -All Plans | $20 | 416% |
| Healthy Blue Mcr Adv | $20 | 416% |
| UnitedHealthcare | $27 - $42 | 561% |
| First Health - All Plans | $37 | 769% |
| Aetna | $37 | 769% |
| Cigna | $39 | 811% |
| Medicaid / KanCare | $42 | 873% |
| Coventry Mcaid-All Plans | $42 | 873% |
| Healthy Blue Mcaid- All Other Plans | $42 | 873% |
| Providers Care-Wppa-All Plans | $62 | 1289% |
Consumer Guidance & Cost Commentary
For this blood test for sodium at Ellsworth County Medical Center, the cash price is $42.00, which matches the facility's gross charge and the cash median. This rate is significantly higher than the state average for this service, which is $4.81, and exceeds the Medicare benchmark of $4.81 by 7.7 times. While commercial insurance plans like Blue Cross Blue Shield and Humana negotiate rates ranging from $10 to $42, these negotiated amounts often exceed the cash price. Patients with high-deductible plans may find it financially advantageous to pay the $42.00 cash price directly, as doing so avoids the administrative overhead and potential higher negotiated rates that insurers charge. It is important to verify your specific plan's deductible status before scheduling, as paying out-of-pocket might be cheaper if your insurance has not yet covered the cost.
To ensure you are not overcharged, always request a detailed, itemized bill before finalizing payment. Hospitals often issue summary bills that obscure individual line items, making it difficult to spot errors such as unbundled codes or services not rendered. Since over 80% of hospital bills contain errors, asking for a full CPT-coded statement is the most effective way to identify and dispute any mistakes. Additionally, if you choose to pay with insurance, be aware that balance billing can occur if out-of-network providers are involved, though the No Surprises Act protects patients from such surprise bills for emergency and non-emergency services at in-network facilities. Finally, consider asking the facility about prompt-pay discounts, which can reduce the final amount by 20% to 50% if you settle the bill in full upfront, bypassing