Blood test, sodium
Facility: Stevens County Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $16
- Cash Discount Price: $43
- vs. Medicare Baseline: 3.33x 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 333% of the Medicare baseline (a markup of 233%). 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 |
|---|---|---|
| Aetna | $2 - $43 | 42% |
| Blue Cross Blue Shield | $10 | 208% |
| Humana | $16 | 333% |
| First Health - All Plans | $39 | 811% |
| Wppa - All Plans | $41 | 852% |
| Medicaid / KanCare | $43 | 894% |
Consumer Guidance & Cost Commentary
For this blood test for sodium at Stevens County Hospital in Hugoton, Kansas, the cash price is $43.00, which matches the facility's negotiated rate for Medicaid and the highest negotiated rates for First Health and WPPA. While the facility is a Critical Access Hospital with a government-local ownership structure, the cash price is notably higher than the state average for this service. Patients with high-deductible plans should consider paying the cash price directly, as it may be lower than their insurance's negotiated rate if they have not yet met their deductible. It is important to verify the specific allowed amount with your insurer before scheduling, as in-network rates can vary significantly between providers.
The Medicare benchmark for this procedure is $4.81, which serves as a baseline for evaluating the facility's pricing markup. The facility's cash price of $43.00 represents a significant markup compared to the federal government's fixed reimbursement rate. To minimize costs, patients should inquire about self-pay or prompt-pay discounts, which can reduce the bill by 20% to 50% if paid upfront. Additionally, if you receive an itemized bill, request a full line-by-line audit to identify any errors, double-billing, or unbundled codes, as over 80% of hospital bills contain inaccuracies. Always check your deductible status and ensure you are not inadvertently agreeing to balance billing by signing unnecessary waivers before your visit.