Blood test, sodium
Facility: Osborne County Memorial Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $31
- Cash Discount Price: $29
- vs. Medicare Baseline: 6.44x 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 644% of the Medicare baseline (a markup of 544%). 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 |
|---|---|---|
| UnitedHealthcare | $26 | 541% |
| Health Partners Of Kansas | $29 | 603% |
| Wppa | $32 | 665% |
| Blue Cross Blue Shield | $33 | 686% |
Consumer Guidance & Cost Commentary
For the blood test for sodium (CPT code 84295) at Osborne County Memorial Hospital in Osborne, KS, the facility's cash price of $29.00 is notably lower than the gross charge of $34.00 and aligns closely with the state average. While the hospital is a Critical Access Hospital owned by the local government, the negotiated rates for in-network payers like UnitedHealthcare and Blue Cross Blue Shield range from $26.00 to $33.00, which are higher than the cash price. This pricing structure illustrates a common billing dynamic where commercial insurance contracts often exceed cash-pay rates due to administrative costs and contract dynamics; however, patients with high-deductible plans may find the cash price more affordable if their insurance allows them to pay out-of-pocket without meeting their deductible first.
To maximize savings, patients should verify their specific plan's negotiated rate before scheduling, as in-network rates can vary significantly even at the same facility. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, unexpected charges can still occur if ancillary services are not covered. Additionally, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid upfront, bypassing the administrative overhead of insurance claims. Since over 80% of hospital bills contain errors, consumers are encouraged to request a detailed, itemized bill to review specific CPT codes and ensure no services were double-billed or unbundled before finalizing payment.