Blood test, sodium
Facility: Golden Valley Memorial Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $5
- Cash Discount Price: $43
- vs. Medicare Baseline: 1.04x 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.
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 |
|---|---|---|
| Aetna | $5 | 104% |
| Home State Health | $5 | 104% |
| Humana | $5 | 104% |
| UnitedHealthcare | $5 - $8 | 104% |
| Ambetter / Centene | $6 | 125% |
Consumer Guidance & Cost Commentary
For a self-pay patient, the most important thing to know is that the cash price for this blood test, sodium, is $43, which is significantly lower than the facility's gross charge of $72. While the facility is a Government-owned Acute Care Hospital in Clinton, Missouri, patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fees can sometimes be cheaper than what insurance companies negotiate. In this specific case, the negotiated rate of $5 is lower than the cash price, but patients with high-deductible plans should verify whether their out-of-pocket costs will exceed the cash rate, as paying directly can sometimes result in a lower total bill if the insurance allowed amount is high.
The broader rate context shows that the facility's cash rate of $43 is higher than the median negotiated rate of $5 and the Medicare amount of $4.81, which serves as a benchmark for the true cost of care. Although the data does not provide specific county or state average comparisons for this exact CPT code, the stark difference between the gross charge and the cash price highlights the importance of comparing rates against the Medicare baseline rather than the hospital's list price. Because the facility is in-network for five payers including Aetna, Home State Health, Humana, UnitedHealthcare, and Ambetter / Centene, patients should be aware that while the negotiated rate is low, the actual amount paid depends on whether the patient has met their deductible, and they should request an itemized audit if any unexpected charges appear on their final statement.