Blood test, sodium
Facility: St Luke Hospital & Living Center
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $32
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 6.65x 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 665% of the Medicare baseline (a markup of 565%). 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 |
|---|---|---|
| Kansas Department Of Health And Environment | $32 | 665% |
| Humana | $32 | 665% |
| UnitedHealthcare | $32 | 665% |
| Blue Cross Blue Shield | $32 | 665% |
| Va Ccn | $32 | 665% |
| Bluestem Pace | $32 | 665% |
| Ambetter / Centene | $32 | 665% |
Consumer Guidance & Cost Commentary
For the blood test for sodium (CPT 84295) at St Luke Hospital & Living Center in Marion, KS, the facility's negotiated rate is $32.00, which matches the lowest and highest rates reported across all seven payers, including UnitedHealthcare, Humana, and the Kansas Department of Health And Environment. This negotiated amount is significantly lower than the facility's gross charge of $62.00, reflecting the standard administrative markup inherent in insurance contracts. When compared to the Medicare benchmark of $4.81, the negotiated rate represents a substantial markup, illustrating how commercial insurance contracts often exceed the federal government's cost-based baseline. For patients with high-deductible plans, the cash price is not listed in this report, but it is worth noting that cash-pay options can sometimes be cheaper than the insurance negotiated rate if the patient's deductible has not yet been met.
Patients should be aware that the facility, a Critical Access Hospital owned by a Government Hospital District, may offer additional discounts for self-pay or prompt-pay arrangements, which can bypass the administrative costs associated with insurance billing. Since the No Surprises Act prohibits balance billing for out-of-network services at in-network facilities, patients can expect the $32.00 negotiated rate to be the maximum amount charged by the hospital for this service when using in-network insurance. To ensure you are receiving the most accurate pricing, always request an itemized bill before paying, as summary bills may obscure individual line items or unbundled charges. If you receive a bill that appears higher than the negotiated rate, you have the right to request a formal audit to identify any errors or double-billing before finalizing payment.