Blood test, sodium
Facility: Morris County Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $22
- Cash Discount Price: $34
- vs. Medicare Baseline: 4.57x 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 457% of the Medicare baseline (a markup of 357%). 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 |
|---|---|---|
| Va Ccn-All Plans | $3 | 62% |
| Providrs Care (Wppa)(Nexus)-All Plans | $5 | 104% |
| Aetna | $6 | 125% |
| Blue Cross Blue Shield | $10 - $22 | 208% |
| UnitedHealthcare | $22 - $56 | 457% |
| Choice Care Mcr Adv-All Plans | $22 | 457% |
| Coventry Mcr | $22 | 457% |
| Cigna | $41 | 852% |
| Multiplan-All Plans | $50 | 1040% |
| Coventry Comm-All Other Plans | $50 | 1040% |
Consumer Guidance & Cost Commentary
For this blood test for sodium at Morris County Hospital in Council Grove, Kansas, the cash median price is $34.00, which is lower than the facility's gross charge of $56.00. While the facility is a Critical Access Hospital with government local ownership, patients should note that commercial insurance negotiated rates often exceed cash prices due to administrative costs and contract structures. For instance, UnitedHealthcare and Blue Cross Blue Shield have negotiated ranges starting at $22.00 and going up to $56.00, meaning paying cash directly could result in lower out-of-pocket costs if your insurance deductible has not yet been met. It is always advisable to ask the hospital about self-pay or prompt-pay discounts before scheduling, as these upfront payment incentives can bypass the higher administrative fees associated with insurance billing cycles.
When evaluating this service, it is important to compare rates against the Medicare benchmark rather than the hospital's full list price. The Medicare amount for this code is $4.81, and the facility's cash rate of $34.00 represents a significant markup above this federal baseline, which is typical for commercial pricing but worth understanding to avoid confusion. If you receive an itemized bill later, ensure it breaks down the specific CPT code to prevent errors or double-charging, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit. By understanding that commercial rates often average 200% to 300% of Medicare while fair pricing typically aligns closer to 120% to 150%, you can better assess whether the final charge is reasonable or if a dispute is warranted.