Blood test, sodium
Facility: Hospital District #6 Patterson Health Center
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $23
- Cash Discount Price: $20
- vs. Medicare Baseline: 4.78x 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 478% of the Medicare baseline (a markup of 378%). 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% |
| UnitedHealthcare | $22 - $25 | 457% |
| Providers Care (Wppa)-All Plans | $44 | 915% |
Consumer Guidance & Cost Commentary
For the blood test for sodium (CPT 84295) at Hospital District #6 Patterson Health Center in Anthony, KS, the facility's cash median price is $20.00, which is lower than the negotiated rates of $23.00 paid by UnitedHealthcare and Providers Care. While the facility is a Critical Access Hospital owned by the government, patients with high-deductible plans may find paying the $20.00 cash price directly more beneficial than relying on insurance, as the negotiated rates exceed the cash amount. To secure the lowest possible cost, it is advisable to ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill by bypassing administrative claim processing fees.
When evaluating this price, it is important to compare it against the Medicare benchmark rather than the facility's gross charge of $25.00. The Medicare amount for this service is $4.81, meaning the cash price of $20.00 represents a significant markup over the federal baseline, which serves as the objective standard for healthcare costs. Although the data does not provide specific state or county average comparisons for this exact code, the principle of Medicare benchmarking remains the most reliable method for understanding the true cost of care. Consumers should avoid accepting summary bills and instead request a detailed, itemized statement to ensure no errors or unbundled charges are included in the final invoice.