Blood test, sodium
Facility: Trego County Lemke Memorial Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $14
- Cash Discount Price: $14
- 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 |
|---|---|---|
| Humana | $8 | 166% |
| Tricare | $8 | 166% |
| Medicaid / KanCare | $10 - $16 | 208% |
| Aetna | $10 - $14 | 208% |
| UnitedHealthcare | $10 - $16 | 208% |
| Ambetter / Centene | $11 | 229% |
| Blue Cross Blue Shield | $14 | 291% |
| Health Partners - All Plans | $15 | 312% |
| Healthy Blue Mcaid - All Plans | $16 | 333% |
Consumer Guidance & Cost Commentary
For the blood test for sodium (CPT code 84295) at Trego County Lemke Memorial Hospital in Wakeeney, Kansas, the facility's cash median rate is $14.00, which is lower than the state average of $16.00. While the facility's negotiated rates with major payers like Humana, Tricare, and UnitedHealthcare range from $8.00 to $16.00, these amounts often exceed the cash price. Patients with high-deductible plans may find it financially advantageous to pay the cash rate of $14.00 directly, as the insurance negotiated rates can sometimes be higher than the out-of-pocket cash cost. To secure the best possible price, it is recommended to ask the hospital specifically about "self-pay" or "prompt-pay" discounts before scheduling the service, as these upfront payment incentives can further reduce the total amount owed.
The facility's Medicare benchmark for this service is $4.81, which serves as a critical baseline for evaluating pricing fairness. Although the facility's negotiated rates are significantly higher than the Medicare amount, this markup is standard for commercial insurance contracts that include administrative processing costs. If a patient receives care from an out-of-network provider or encounters unexpected charges, they may face balance billing, where the provider bills the difference between the full chargemaster rate and the insurance allowed amount. To avoid surprise costs, patients should request a full itemized bill before paying and dispute any errors in writing, as over 80% of hospital bills contain mistakes that can be corrected through a formal audit.