Blood test, sodium
Facility: Hiawatha Community Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $38
- Cash Discount Price: $49
- vs. Medicare Baseline: 7.90x 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 790% of the Medicare baseline (a markup of 690%). 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 | $18 | 374% |
| Aetna | $18 - $40 | 374% |
| UnitedHealthcare | $18 - $42 | 374% |
| Ambetter / Centene | $22 | 457% |
| Centrus Health Direct - All Plans | $37 | 769% |
| Oscar - All Plans | $37 | 769% |
| Preferred Hlth - All Plans | $44 | 915% |
| Cigna | $47 | 977% |
| Wppa Providrs Care - All Plans | $47 | 977% |
| Multiplan - All Plans | $48 | 998% |
| Midlands Choice - All Plans | $48 | 998% |
| Healthy Blue Mcaid - All Plans | $49 | 1019% |
Consumer Guidance & Cost Commentary
For the blood test for sodium (CPT 84295) at Hiawatha Community Hospital in Hiawatha, KS, the cash price is $49.00, which matches the facility's gross charge and the median paid amount. This cash rate is significantly higher than the state average for this service, as indicated by the 7.9% variance compared to Medicare benchmarks. While commercial insurance plans like Blue Cross Blue Shield and Humana have negotiated rates ranging from $10 to $42, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying the full cash price of $49.00 directly rather than relying on insurance reimbursement, provided they have not yet met their deductible.
Patients should be aware that while the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the final cost depends heavily on payment timing and method. The facility offers a prompt-pay discount for upfront payments, which can reduce the bill further than the listed cash rate. It is crucial to request a self-pay classification before scheduling to avoid automatic claims submission that could void cash discounts. Additionally, if you receive a bill from an out-of-network provider or a specific ancillary service, you may be subject to balance billing for the difference between the allowed amount and the full charge; however, the No Surprises Act protects you from such surprise bills for emergency care and non-emergency services at in-network facilities. Always demand a detailed, itemized bill to verify that all charges are accurate and that no unbundled codes or services not rendered have been included.