Blood test, sodium
Facility: Sheridan County Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $14
- Cash Discount Price: $22
- vs. Medicare Baseline: 2.91x 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 291% of the Medicare baseline (a markup of 191%). 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 |
|---|---|---|
| Celtic Insurance | $13 | 270% |
| Blue Cross Blue Shield | $14 | 291% |
| UnitedHealthcare | $21 | 437% |
Consumer Guidance & Cost Commentary
For the blood test for sodium (CPT 84295) at Sheridan County Hospital in Hoxie, KS, the cash price is $22.00, which matches the facility's median negotiated rate of $14.00 when adjusted for the specific payer context. This service is benchmarked against Medicare, which sets a fixed reimbursement rate of $4.81 for this procedure. While commercial insurance contracts often result in rates significantly higher than the Medicare baseline, the cash price here is notably higher than the Medicare amount, illustrating that for patients with high-deductible plans, paying cash upfront can sometimes be more cost-effective than relying on insurance if the negotiated rate exceeds the cash price. It is important to note that while the facility is a Critical Access Hospital owned by the local government, patients should verify their specific plan's allowed amount before scheduling, as in-network rates vary by carrier and do not guarantee the lowest possible price.
Patients should be aware that hospitals frequently offer prompt-pay discounts, typically ranging from 20% to 50%, for those who settle their bill in full before the insurance claim is processed. Since this facility's cash price is already $22.00, asking for a prompt-pay discount could potentially lower the final cost further, bypassing the administrative overhead and potential delays associated with insurance billing. Additionally, under the No Surprises Act, patients are protected from balance billing for out-of-network services at in-network facilities, though it remains crucial to request an itemized bill to ensure no unbundled codes or services not rendered are included. Given that over 80% of hospital bills contain errors, consumers are encouraged to review their statement line-by-line and dispute any