Blood test, sodium
Facility: Great Plains Of Sabetha
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $25
- Cash Discount Price: $26
- vs. Medicare Baseline: 5.20x 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 520% of the Medicare baseline (a markup of 420%). 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 | $14 - $26 | 291% |
| Celtic Mcr Adv | $14 | 291% |
| Celtic Comm Exchange-All Other Plans | $17 | 353% |
| Great West Healthcare-All Plans | $22 | 457% |
| UnitedHealthcare | $24 - $26 | 499% |
| Century/Wppa/Providers-All Plans | $25 | 520% |
| Federated Mutual Ins-All Plans | $25 | 520% |
| Cigna | $25 | 520% |
| Humana | $25 | 520% |
| Multiplan-Phcs-All Plans | $25 | 520% |
| Medicaid / KanCare | $26 | 541% |
| Blue Cross Blue Shield | $26 | 541% |
Consumer Guidance & Cost Commentary
For this blood test for sodium at Great Plains Of Sabetha in Sabetha, Kansas, the facility's cash price is $26.00, which matches the gross chargemaster rate. While the median negotiated rate across 12 payers is $25.00, the cash price remains the lowest option available for this service. Patients with high-deductible plans or those without insurance may find paying the full cash price of $26.00 more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. It is important to note that while the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the specific negotiated rates vary by insurer, ranging from $14.00 for Aetna to $26.00 for Medicaid/KanCare and UnitedHealthcare.
To ensure you are not overcharged, always request a full itemized bill before paying, as summary bills can obscure individual line items and potential errors. If you receive a balance bill for the difference between the provider's full charge and your insurance allowed amount, you may be protected under the No Surprises Act if the care was provided at an in-network facility or involved emergency services. Additionally, ask the billing department about prompt-pay discounts, which can reduce the final cost if you settle the bill upfront, though these discounts are not guaranteed and must be requested prior to scheduling. Given that the Medicare benchmark for this code is $4.81, the commercial rates reflect significant markups typical of the healthcare system, making it essential to compare your specific allowed amount against the cash price rather than the hospital's list price.