Blood test, sodium
Facility: Clara Barton Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $33
- Cash Discount Price: $26
- vs. Medicare Baseline: 6.86x 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 686% of the Medicare baseline (a markup of 586%). 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% |
| 6 Degrees Health - All Plans | $26 | 541% |
| Wppa-All Plans | $30 | 624% |
| UnitedHealthcare | $33 | 686% |
| Phcs - All Plans | $33 | 686% |
| Aetna | $33 | 686% |
| Hlth Partners Of Ks-All Plans | $34 | 707% |
Consumer Guidance & Cost Commentary
For this blood test at Clara Barton Hospital in Hoisington, KS, the facility's cash price of $26.00 is notably lower than the state average, which sits at $33.00. While the hospital's negotiated rate with most payers is $33.00, patients with high-deductible plans might find paying the cash price directly more beneficial, as it avoids the administrative overhead and potential deductibles associated with insurance claims. It is important to note that the facility's cash rate is also lower than the Medicare benchmark of $4.81 when adjusted for local costs, suggesting the cash option represents a fair value compared to federal standards.
Before scheduling, patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed by bypassing the costly insurance billing cycle. Although the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the negotiated rates across seven payers remain consistent at $33.00, reflecting standard contract dynamics where administrative processing inflates the baseline price. Consumers are advised to request an itemized bill prior to payment to ensure no errors exist, as over 80% of hospital bills contain discrepancies, and to confirm that any ancillary services do not trigger unexpected balance billing protections under the No Surprises Act.