Blood test, sodium
Facility: Lindsborg Community Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $52
- Cash Discount Price: $40
- vs. Medicare Baseline: 10.81x 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 1081% of the Medicare baseline (a markup of 981%). 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 | 208% |
| Coventry Mcr Adv | $27 | 561% |
| Tricare | $27 | 561% |
| Cigna | $48 | 998% |
| Coventry Comm-All Other Plans | $51 | 1060% |
| UnitedHealthcare | $51 | 1060% |
| Phcs Preferred-All Plans | $53 | 1102% |
| Multiplan-All Plans | $53 | 1102% |
| Health Partners -All Plans | $54 | 1123% |
| Wppa-All Plans | $54 | 1123% |
| Coventry Wc | $54 | 1123% |
| Century Health-All Plans | $54 | 1123% |
Consumer Guidance & Cost Commentary
For the blood test for sodium (CPT 84295) at Lindsborg Community Hospital, the cash price of $40.00 is lower than the facility's negotiated rates, which range from $10 to $57.00 depending on the insurance carrier. While the facility is a Critical Access Hospital in Lindsborg, KS, this specific service does not include a direct comparison to Kansas state or county averages in the provided data. However, for patients with high-deductible plans, paying the cash price of $40.00 upfront can be more cost-effective than relying on insurance, as the negotiated rates for in-network payers like Coventry Mcr Adv and Tricare are significantly higher. Patients should verify their specific plan's deductible status and ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can reduce the final cost.
It is important to understand that commercial insurance rates often exceed cash prices due to administrative overhead and contract dynamics, meaning the lowest price is not always the negotiated rate. If you are billed more than the cash price, you may be facing balance billing if your provider is out-of-network, though the No Surprises Act protects you from such surprise bills for emergency care and non-emergency services at in-network facilities. To ensure you are not overcharged, always request a full itemized bill rather than accepting a summary invoice, and dispute any errors in writing to avoid unnecessary debt. By comparing the cash price against your specific insurance allowed amount and seeking prompt-pay discounts, you can make informed decisions that minimize out-of-pocket expenses.