Blood test, sodium
Facility: Cloud County Health Center
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $54
- Cash Discount Price: $40
- vs. Medicare Baseline: 11.23x 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 1123% of the Medicare baseline (a markup of 1023%). 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 |
|---|---|---|
| Aetna | $51 - $53 | 1060% |
| Mpi-All Plans | $54 | 1123% |
| Pponext-All Plans | $54 | 1123% |
| Health Partners - All Plans | $54 | 1123% |
Consumer Guidance & Cost Commentary
For the blood test for sodium (CPT 84295) at Cloud County Health Center in Concordia, KS, the facility's cash price of $40.00 is lower than the median negotiated rate of $54.00 paid by major payers like Aetna and Mpi-All Plans. This price transparency data indicates that patients with high-deductible plans or those without insurance may save money by paying the cash price directly, as the negotiated rates often exceed the cash amount. However, patients should verify their specific plan's deductible status before scheduling, as paying the full negotiated rate upfront without meeting a deductible could result in higher out-of-pocket costs than expected. Additionally, the facility offers a prompt-pay discount, which can further reduce the final bill if paid in full within a short window, bypassing the administrative overhead associated with insurance claims processing.
When evaluating the cost of this service, it is important to compare rates against the Medicare benchmark rather than the facility's gross charge. The Medicare amount for this procedure is $4.81, and the facility's cash price of $40.00 represents a significant markup above this federal baseline, which is common for commercial services. While the data does not provide specific county or state averages for this code, the principle of Medicare benchmarking remains the most reliable method for understanding the true cost of care and identifying potential overcharges. Consumers are advised to request an itemized bill to ensure no unbundled codes or services not rendered are included, as summary bills can obscure individual line items. If a balance bill arises from an out-of-network ancillary service, patients should dispute the charge with the insurer under the No Surprises Act rather than paying