Blood test, sodium
Facility: Clay County Medical Center
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $38
- Cash Discount Price: $40
- vs. Medicare Baseline: 7.90x 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 790% of the Medicare baseline (a markup of 690%). 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 |
|---|---|---|
| Wppa/Providrs Care- All Plans | $37 | 769% |
| Aetna | $37 | 769% |
| Multiplan- All Plans | $38 | 790% |
| UnitedHealthcare | $38 | 790% |
| Health Partners - All Plans | $38 | 790% |
Consumer Guidance & Cost Commentary
For the blood test for sodium (CPT 84295) at Clay County Medical Center in Clay Center, KS, the facility's cash price is $40.00, which matches the median cash rate for this service in the state. While the facility is a Critical Access Hospital owned by the local government, the negotiated rates for in-network payers such as Aetna and UnitedHealthcare average $38.00, slightly lower than the cash price. This pricing structure suggests that for patients with high-deductible plans or those without insurance, paying the cash price directly may be more cost-effective than relying on insurance, as the insurer's allowed amount often exceeds the cash rate. Patients should verify their specific plan's deductible status before scheduling, as paying out-of-pocket could result in immediate savings compared to the administrative costs and potential deductibles associated with using insurance.
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 like specific lab components are billed separately. To ensure you receive the most accurate pricing, always request an itemized bill before paying, as summary invoices may obscure individual code costs or unbundled charges. Additionally, since the facility offers a cash price of $40.00, you should explicitly ask about "prompt-pay" discounts or self-pay rates at registration; these upfront payment incentives can reduce the final amount owed by bypassing the insurance claims cycle. If you receive a bill that seems inconsistent with the $38.00 negotiated rate or the $40.00 cash price, you have the right to dispute it in writing with the billing