Blood test, sodium
Facility: Lincoln County Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $10
- Cash Discount Price: $43
- vs. Medicare Baseline: 2.08x 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 208% of the Medicare baseline (a markup of 108%). 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% |
Consumer Guidance & Cost Commentary
For this blood test for sodium at Lincoln County Hospital in Lincoln, KS, the cash price of $43.00 is notably higher than the facility's negotiated rate of $10.00, which is the only rate available from Blue Cross Blue Shield. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans might find the cash price more affordable if their insurance negotiated rate exceeds this amount, though the data indicates the negotiated rate is the primary benchmark here. It is important to note that while the facility is in-network, specific lab services can sometimes trigger balance billing if they are out-of-network, though the No Surprises Act generally protects patients from such unexpected charges for emergency or non-emergency services at in-network facilities.
To ensure you are not overcharged, always request a full itemized bill before paying, as summary invoices often hide unbundled codes or services not rendered. If you receive a balance bill, do not pay it immediately; instead, dispute the charge with your insurer and request a No Surprises Act audit if applicable. Additionally, ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid upfront, bypassing costly administrative processing fees. Since the facility is a Critical Access Hospital, its pricing structure may differ from larger regional centers, so verifying the exact allowed amount with your insurance before scheduling is the most effective way to avoid surprise costs.