Blood test, sodium
Facility: Bob Wilson Memorial Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $36
- Cash Discount Price: $17
- vs. Medicare Baseline: 7.48x 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 748% of the Medicare baseline (a markup of 648%). 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 |
|---|---|---|
| Centura Employee Plan | $6 | 125% |
| UnitedHealthcare | $14 - $36 | 291% |
| Blue Cross Blue Shield | $14 | 291% |
| Medicare (plans) | $14 | 291% |
| Aetna | $14 - $35 | 291% |
| Humana | $14 | 291% |
| Kansas Health | $14 | 291% |
| Multiplan | $39 - $40 | 811% |
| Wppa | $41 | 852% |
| Health Partners Of Kansas | $41 | 852% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Bob Wilson Memorial Hospital in Ulysses, KS, the facility's cash median rate is $17.00, which is significantly lower than the negotiated rates paid by major insurers like UnitedHealthcare ($14–$36), Aetna ($14–$35), and Multiplan ($39–$40). While commercial insurance contracts often result in higher allowed amounts due to administrative overhead and network tiering, patients with high-deductible plans may find paying the cash price directly more cost-effective if their insurance allowed amount exceeds $17.00. It is important to note that while the facility is a Critical Access Hospital owned by a voluntary non-profit church, the data does not provide a specific state or county average for comparison; however, the cash rate remains a strong baseline for self-pay patients to consider before scheduling.
The Medicare benchmark for this service is $4.81, which serves as a critical reference point to understand the facility's pricing structure. The cash rate of $17.00 represents a markup over the Medicare amount, whereas the median negotiated rate of $36.00 reflects the contractual agreements with commercial payers. Patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, but unexpected charges can still occur if ancillary services are out-of-network. To minimize costs, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can offer further reductions for upfront payment, and always request a detailed, itemized bill to verify that no unbundled codes or services not rendered have been included.