Blood test, sodium
Facility: Phillips County Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $29
- Cash Discount Price: $27
- vs. Medicare Baseline: 6.03x 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 603% of the Medicare baseline (a markup of 503%). 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 - $26 | 208% |
| UnitedHealthcare | $26 - $32 | 541% |
| Health Partners-All Plans | $32 | 665% |
| Medicaid / KanCare | $32 | 665% |
Consumer Guidance & Cost Commentary
For the blood test for sodium (CPT 84295) at Phillips County Hospital in Phillipsburg, Kansas, the facility's cash median price of $27.00 is notably higher than the state average of $26.00. While commercial insurance plans like Blue Cross Blue Shield and UnitedHealthcare negotiate rates ranging from $10 to $32, these negotiated amounts often exceed the cash price due to administrative overhead and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the $27.00 rate is lower than the typical negotiated ceiling many insurers apply, potentially saving money on this specific service.
To maximize savings, it is essential to verify the facility's "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can significantly reduce the final bill by bypassing costly claims processing. Additionally, comparing the facility's pricing to the Medicare benchmark of $4.81 reveals a substantial markup, highlighting that commercial rates often reflect a complex pricing model rather than the true cost of care. Since over 80% of hospital bills contain errors, consumers should request a detailed, itemized statement to audit charges for unbundled codes or services not rendered, ensuring the final amount reflects accurate, transparent pricing rather than inflated summary totals.