Blood test, sodium
Facility: Kiowa County Memorial Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $28
- Cash Discount Price: $27
- vs. Medicare Baseline: 5.82x 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 582% of the Medicare baseline (a markup of 482%). 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 - $28 | 208% |
| UnitedHealthcare | $26 - $32 | 541% |
| Humana | $28 | 582% |
| Medica Prime Mcare Cost-All Plans | $28 | 582% |
| Health Partners Of Ks-All Plans | $28 | 582% |
| Aetna | $28 | 582% |
| Celtic Comml Exchange-All Other Plans | $28 | 582% |
| Medicaid / KanCare | $32 | 665% |
| Providrs Care/Wppa-All Plans | $48 | 998% |
Consumer Guidance & Cost Commentary
For this blood test for sodium at Kiowa County Memorial Hospital in Greensburg, KS, the negotiated rates for in-network payers range from $26 to $48, with a median negotiated amount of $28.00. While the facility's cash price is $27.00, which is slightly lower than the negotiated rates, patients with high-deductible plans may find paying cash directly more cost-effective if their insurance allows a higher negotiated rate than the cash price. It is important to note that this facility is a Critical Access Hospital owned by the local government, and while the data does not provide a specific county or state average for comparison, patients should verify their specific plan's allowed amount before scheduling to ensure they are aware of their potential out-of-pocket costs.
Patients should be aware that commercial insurance rates often include administrative overhead and contract dynamics that can result in higher prices than the direct cash price. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to request a full itemized bill before paying to identify any errors or unbundled charges. Additionally, if you are paying out-of-network or have a balance due, you may qualify for a prompt-pay discount by paying your bill in full upfront, which can significantly reduce the total amount owed. Always confirm with the hospital's billing department regarding self-pay rates and any available discounts before finalizing payment.