Blood test, sodium
Facility: Fredonia Regional Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $23
- Cash Discount Price: $26
- vs. Medicare Baseline: 4.78x 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 478% of the Medicare baseline (a markup of 378%). 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 | $1 - $23 | 21% |
| Blue Cross Blue Shield | $10 - $13 | 208% |
| Aetna | $13 - $23 | 270% |
| Veterans Programs - All Plans | $13 | 270% |
| Cigna | $23 | 478% |
| Meritain-All Plans | $23 | 478% |
| Reserve National-All Plans | $23 | 478% |
Consumer Guidance & Cost Commentary
For the blood test for sodium (CPT 84295) at Fredonia Regional Hospital in Kansas, the cash price is $26.00, which matches the facility's median negotiated rate of $23.00 and the Medicare benchmark of $4.81. While the facility is a Critical Access Hospital owned by the local government, the cash price is significantly higher than the Medicare rate, reflecting standard commercial pricing structures where negotiated rates often range from 200% to 300% of the federal baseline. Because the cash price is already lower than the typical commercial negotiated rates found in the market, patients with high-deductible plans may find paying out-of-pocket directly to the hospital more cost-effective than using insurance, provided they can secure the cash price rather than the higher allowed amount.
To minimize costs, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing administrative claim processing fees. It is also important to request a full itemized bill to verify that no services were unbundled or double-charged, as over 80% of hospital bills contain errors that can be corrected through a formal written audit. Given that the facility is in-network for seven major payers including UnitedHealthcare and Blue Cross Blue Shield, patients should confirm their specific deductible status before proceeding, as using insurance without meeting the deductible could result in paying the full negotiated rate of $23.00 rather than the lower cash price.