Blood test, sodium
Facility: Children'S Mercy South
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $37
- Cash Discount Price: $27
- vs. Medicare Baseline: 7.69x 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 769% of the Medicare baseline (a markup of 669%). 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 - $38 | 83% |
| Healthy Blue | $5 - $13 | 104% |
| Medicaid / KanCare | $5 | 104% |
| Home State Health | $12 | 249% |
| Blue Cross Blue Shield | $23 - $42 | 478% |
| Cigna | $27 - $40 | 561% |
| Medica | $33 | 686% |
| Aetna | $34 - $39 | 707% |
| Health Midwest Comprehensive Care | $37 | 769% |
| Centivo | $37 | 769% |
| Quiktrip | $37 | 769% |
| Orscheln | $37 | 769% |
| Wppa Providrs Care | $37 | 769% |
| Wellfit/Centrus | $37 | 769% |
| Nebraska Furniture Mart | $37 | 769% |
| Humana | $38 | 790% |
| Coventry Health Care Of Kansas | $42 | 873% |
| Coxhealth Network | $42 | 873% |
| Mercy Health | $43 | 894% |
| Multiplan | $43 | 894% |
| American Healthcare Alliance | $48 | 998% |
| Healthlink | $50 | 1040% |
| National Preferred Provider Network | $51 | 1060% |
Consumer Guidance & Cost Commentary
For the blood test for sodium (CPT 84295) at Children's Mercy South in Overland Park, KS, the facility's cash median price is $27.00, which is significantly lower than the state average of $37.00. While many commercial payers have negotiated rates ranging from $4 to $51, the cash price remains the most affordable option for patients without insurance or those with high-deductible plans. Because commercial negotiated rates often include administrative overhead and contract markups that can exceed 200% of Medicare rates, paying cash directly can result in substantial savings compared to what an insurer might allow. Patients should verify their specific plan's deductible status before scheduling, as paying the full negotiated rate may not be cost-effective if the deductible has not yet been met.
To ensure you are not overcharged, it is important to understand that hospitals often issue summary bills that obscure individual line items, making it difficult to spot errors or unbundled charges. Before finalizing payment, request a full itemized CPT-coded statement to review every service rendered and identify any discrepancies. Additionally, if you are self-paying, ask the billing department about "prompt-pay" discounts, which can reduce the total amount due by 20% to 50% if settled within 30 days. This upfront payment bypasses the costly insurance claims cycle and administrative fees, providing immediate liquidity to the facility while offering you a lower final price. Always confirm that your payment is classified as "self-pay" to secure these discounts and avoid unexpected balance billing.