Blood test, sodium
Facility: Goodland Regional Medical Center
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $48
- Cash Discount Price: $48
- vs. Medicare Baseline: 9.98x 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 998% of the Medicare baseline (a markup of 898%). 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% |
| Wppa | $45 - $48 | 936% |
| UnitedHealthcare | $48 | 998% |
Consumer Guidance & Cost Commentary
For the blood test for sodium at Goodland Regional Medical Center, the cash price of $48.00 is notably higher than the Medicare benchmark of $4.81, reflecting a markup of 1000% over the federal baseline. While the facility's negotiated rates with payers like Blue Cross Blue Shield and UnitedHealthcare range between $45 and $48, these amounts remain significantly above the Medicare rate, illustrating that commercial contracts often exceed the "true cost" of care. In this specific case, the cash price aligns closely with the median negotiated rate, suggesting that for patients with high-deductible plans, paying out-of-pocket might be more cost-effective than relying on insurance, which could result in higher out-of-pocket costs if the deductible is not yet met.
To ensure you are receiving the most accurate pricing, it is crucial to request an itemized bill rather than accepting a summary invoice, as hospitals may obscure individual code costs. If you choose to pay directly, ask specifically about "self-pay" or "prompt-pay" discounts, which can reduce the total by 20% to 50% if settled upfront, bypassing the administrative overhead associated with insurance claims. Given that the facility is a Critical Access Hospital in Kansas, comparing these rates to local averages helps identify if the pricing is standard for the region, but always verify the final allowed amount with the hospital before scheduling to avoid unexpected balance billing or surprise charges.