Blood test, sodium
Facility: Stanton County Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $50
- Cash Discount Price: $53
- vs. Medicare Baseline: 10.40x 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 1040% of the Medicare baseline (a markup of 940%). 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 - $50 | 208% |
| Healthy Blue Mcr Adv - All Other Plans | $51 | 1060% |
| Healthy Blue Mcaid | $52 | 1081% |
Consumer Guidance & Cost Commentary
For this blood test for sodium at Stanton County Hospital in Johnson, KS, the cash price is $53.00, which matches the facility's median negotiated rate. While the hospital is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance plans often pay more than the cash price due to administrative costs and contract structures. In this specific case, the median negotiated rate of $50.00 is slightly lower than the cash price, but patients with high-deductible plans might still find the cash option beneficial if their insurance allowed amount exceeds $53.00. It is important to verify your specific plan's allowed amount before scheduling, as assuming in-network coverage guarantees the lowest price can lead to unexpected costs if the insurer's negotiated rate is higher than the cash rate.
The Medicare benchmark for this service is $4.81, which serves as a baseline for evaluating the facility's pricing markup. The facility's cash price of $53.00 represents a significant increase over the Medicare rate, a common occurrence when commercial rates include additional administrative layers. If you receive a bill from this facility, you should request an itemized audit to ensure no errors exist, as over 80% of hospital bills contain mistakes such as unbundled codes or charges for services not rendered. Additionally, if you are out-of-network or face a balance bill, remember that the No Surprises Act protects you from being billed the difference between the provider's full charge and your insurance payment for emergency care or non-emergency services at in-network facilities. Always ask the hospital directly about self-pay or prompt-pay discounts before check-in to potentially reduce your final cost.