Blood test, sodium
Facility: Oakleaf Surgical Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $5
- Cash Discount Price: $25
- 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 |
|---|---|---|
| Blue Cross Blue Shield | $5 | 104% |
| Dean Health Plan | $5 | 104% |
| Group Health Cooperative Of Eau Claire | $5 | 104% |
| Healthpartners | $5 | 104% |
| Humana | $5 | 104% |
| Medica | $5 | 104% |
| Quartz Health Solutions | $5 | 104% |
| Security Health Plan Of Wi | $5 | 104% |
| Ucare Wi | $5 | 104% |
| UnitedHealthcare | $5 | 104% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Oakleaf Surgical Hospital in Altoona, the facility's cash price of $25 is significantly lower than the state average of $28 and the Medicare benchmark of $4.81. While the cash rate appears modest compared to the gross charge of $28, it is important to note that the Medicare amount serves as the objective baseline for true cost, revealing that commercial rates often carry substantial markups. Patients with high-deductible plans may find the cash price of $25 more advantageous than the negotiated rate of $5, as the insurance allowed amount does not exceed the cash price in this instance.
The hospital offers a cash rate of $25, which is distinct from the standard negotiated rate of $5 seen across all ten participating payers, including Blue Cross Blue Shield, Humana, and UnitedHealthcare. Although the negotiated rate is lower than the cash price, patients should verify their specific deductible status before relying on insurance, as paying the full negotiated amount may not be cost-effective if their plan has not yet met its threshold. To ensure the best financial outcome, we recommend contacting the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill amount.