Blood test, sodium
Facility: Scott County Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $19
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 3.95x 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 395% of the Medicare baseline (a markup of 295%). 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 | $4 - $20 | 83% |
| Humana | $9 | 187% |
| Blue Cross Blue Shield | $10 | 208% |
| Wppa | $13 - $1,200 | 270% |
| Aetna | $19 | 395% |
Consumer Guidance & Cost Commentary
This blood test for sodium at Scott County Hospital in Scott City, KS, has a gross charge of $21.00, which is significantly higher than the state average of $4.81. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the negotiated rates vary widely among payers, ranging from $4 to $1,200 depending on the insurance plan. For patients with high-deductible plans, paying cash directly might be more cost-effective than using insurance, as the negotiated rates often exceed the cash price. It is important to note that while the facility offers a cash median, specific self-pay or prompt-pay discounts should be confirmed directly with the hospital before scheduling to ensure you receive the lowest possible rate.
The Medicare benchmark for this service is $4.81, which serves as a reliable baseline for evaluating the facility's pricing markup rather than the inflated gross charge. Although the facility has a low rating of 2, the actual cost to the patient depends heavily on their specific insurance coverage and whether they are subject to balance billing. If you are out-of-network or receive unexpected ancillary services, the No Surprises Act may protect you from balance billing for emergency care, but it is crucial to request an itemized billing audit to identify any errors, unbundled codes, or services not rendered. Always dispute any surprise bills in writing and avoid signing consent waivers that could waive your rights to fair pricing protections.