Blood test, sodium
Facility: Wilson Medical Center
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $22
- Cash Discount Price: $21
- vs. Medicare Baseline: 4.57x 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 457% of the Medicare baseline (a markup of 357%). 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 - $28 | 208% |
| Humana | $15 | 312% |
| Tricare | $15 | 312% |
| Ambetter / Centene | $15 - $28 | 312% |
| UnitedHealthcare | $15 - $26 | 312% |
| Aetna | $15 - $28 | 312% |
| Cigna | $22 | 457% |
| Health Partners-All Plans | $26 | 541% |
| Mulitplan-All Plans | $26 | 541% |
Consumer Guidance & Cost Commentary
For this blood test for sodium at Wilson Medical Center in Neodesha, KS, the cash price is $21.00, which is lower than the facility's negotiated rates with major payers like Blue Cross Blue Shield, Humana, and Tricare, all of which range from $15.00 to $28.00. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance contracts often result in higher allowed amounts than cash prices due to administrative costs and network tiering. If you have a high-deductible plan, paying the cash price of $21.00 upfront could save you money compared to your insurance paying its negotiated rate of up to $28.00, especially if your deductible has not yet been met.
To ensure you are not overcharged, always request a prompt-pay discount before scheduling, as hospitals often offer 20% to 50% reductions for upfront payment to bypass costly claims processing. If you receive a bill after insurance submission, do not accept a summary invoice; instead, demand a full itemized audit to check for errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes. Finally, compare the facility's pricing to the Medicare benchmark of $4.81; since commercial rates are frequently marked up significantly above this federal baseline, using the Medicare amount as a reference point provides a more accurate view of the facility's true cost structure than the inflated chargemaster list.