Blood test, sodium
Facility: Community Memorial Healthcare, Inc.
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $17
- Cash Discount Price: $29
- vs. Medicare Baseline: 3.53x 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 353% of the Medicare baseline (a markup of 253%). 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% |
| Aetna | $13 - $24 | 270% |
| UnitedHealthcare | $16 - $18 | 333% |
Consumer Guidance & Cost Commentary
For this blood test for sodium at Community Memorial Healthcare, Inc. in Marysville, KS, the cash price is $29.00, which matches the facility's median negotiated rate of $17.00 and the median paid amount of $17.00. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that cash payments can sometimes be more cost-effective than using insurance if their plan's negotiated rate exceeds the cash price. Given that the facility's cash rate is identical to its negotiated rate, there is no immediate financial advantage to paying out-of-pocket for this specific service, but it is always advisable to confirm self-pay or prompt-pay discounts directly with the hospital before scheduling to ensure you are receiving the lowest possible price.
The Medicare benchmark for this service is $4.81, which serves as a baseline for evaluating the facility's pricing markup. Although the data does not provide specific state or county average comparisons for this code, the significant difference between the Medicare rate and the commercial rates highlights the typical administrative and contractual structures that influence pricing. If you encounter a balance bill from an out-of-network provider, such as for ancillary lab services, the No Surprises Act generally protects you from paying the difference between the provider's full charge and your insurance allowed amount for emergency or non-emergency care at an in-network facility. To avoid unexpected costs, always request an itemized bill to verify that all charges are accurate and that no unbundled codes or services not rendered have been included.