Blood test, sodium
Facility: Republic County Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $35
- Cash Discount Price: $29
- vs. Medicare Baseline: 7.28x 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 728% of the Medicare baseline (a markup of 628%). 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 |
|---|---|---|
| Rural Carriers-All Plans | $32 | 665% |
| Aetna | $34 | 707% |
| Meritain-All Plans | $34 | 707% |
| UnitedHealthcare | $35 | 728% |
| First Health-All Plans | $36 | 748% |
| Cigna | $36 | 748% |
| Midlands Choice-All Plans | $36 | 748% |
Consumer Guidance & Cost Commentary
For the blood test for sodium (CPT code 84295) at Republic County Hospital in Belleville, KS, the cash price is $29.00, which is lower than the facility's negotiated rates of $35.00 paid by major insurers like Aetna, UnitedHealthcare, and Cigna. This facility is a Critical Access Hospital with a voluntary non-profit ownership structure, and its cash rate is notably lower than the state of Kansas average for this service. While the facility's gross charge is $38.00, patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the insurance negotiated rate of $35.00 exceeds the cash amount. To maximize savings, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill by bypassing administrative claim processing fees.
The Medicare benchmark for this procedure is $4.81, which serves as a baseline for evaluating the facility's pricing markup. The facility's cash rate of $29.00 represents a significant increase over the Medicare amount, reflecting the costs of local labor and facility operations in the 66935 zip code area. Although the facility has a consumer rating of 3 out of 5, the pricing structure suggests that commercial insurance rates are higher than the cash option. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, it is still prudent to obtain an itemized bill to verify all charges. If a patient receives a summary bill, they should request a full line-by-line statement to