Blood test, sodium
Facility: Amberwell Atchison Association
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $25
- Cash Discount Price: $49
- vs. Medicare Baseline: 5.20x 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 520% of the Medicare baseline (a markup of 420%). 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% |
| UnitedHealthcare | $16 - $88 | 333% |
| Triwest - All Plans | $16 | 333% |
| Va Ccn - All Plans | $16 | 333% |
| Superior Select Mcr Adv - All Plans | $16 | 333% |
| Humana | $16 - $22 | 333% |
| Ambetter / Centene | $25 | 520% |
| Cigna | $27 | 561% |
| Aetna | $27 | 561% |
| Centrus Health Direct - All Plans | $37 | 769% |
| Oscar - All Plans | $37 | 769% |
| Multiplan - All Plans | $38 | 790% |
| Wppa Providrs Care - All Plans | $44 | 915% |
Consumer Guidance & Cost Commentary
For the blood test, sodium procedure (CPT 84295) at Amberwell Atchison Association in Atchison, KS, the cash price is $49.00, which matches the facility's median paid amount. This cash rate is significantly higher than the Medicare benchmark of $4.81, indicating a markup of 5.2 times the federal rate. While commercial insurance plans like Blue Cross Blue Shield and UnitedHealthcare negotiate rates ranging from $10 to $88, these negotiated amounts often exceed the cash price. Patients with high-deductible plans may find it financially beneficial to pay the $49.00 cash rate directly, as this avoids the administrative overhead and potential higher negotiated fees charged by insurers. It is advisable to contact the facility directly to confirm if "self-pay" or "prompt-pay" discounts are available, which could further reduce the out-of-pocket cost.
The facility, a Critical Access Hospital owned by a voluntary non-profit, lists 13 different payers with negotiated rates spanning from $10 to $44. Because commercial rates are often inflated by administrative costs and contract dynamics, relying solely on the insurance allowed amount can result in paying more than the cash price. To protect against unexpected charges, patients should request a full itemized bill before finalizing payment, ensuring no unbundled codes or services not rendered are included. If a balance bill arises from an out-of-network ancillary service, the No Surprises Act may provide legal protection against paying the difference between the provider's chargemaster and the insurance payment. Consumers are encouraged to dispute any summary bills immediately and demand a detailed line-by-line statement to identify errors or overcharges before agreeing