Blood test, sodium
Facility: Susan B Allen Memorial Hospital
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $554
- Cash Discount Price: $7
- vs. Medicare Baseline: 115.18x 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 11518% of the Medicare baseline (a markup of 11418%). 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 | $350 | 7277% |
| Providrs Care | $757 | 15738% |
Consumer Guidance & Cost Commentary
For the blood test for sodium at Susan B Allen Memorial Hospital in El Dorado, KS, the cash median price is $7.00, which is significantly lower than the facility's negotiated rates of $554.00 and the commercial payer rates of $350.00 to $757.00. While commercial insurance plans like UnitedHealthcare and Providrs Care have negotiated ceilings that protect in-network members, these rates often exceed the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the $7.00 rate is substantially lower than the commercial negotiated amounts. However, patients should always verify their specific plan details and ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the final cost.
This service is billed under CPT code 84295, and the facility's cash rate of $7.00 is notably lower than the Medicare benchmark of $4.81, suggesting a potential area for review regarding the facility's pricing structure relative to federal standards. It is important to note that while Medicare rates serve as a baseline for "true cost," commercial rates are often marked up significantly above this figure. To ensure you are not overcharged, we recommend requesting an itemized billing audit to confirm that no unbundled codes or services not rendered are included in the final invoice. If you receive a summary bill, insist on a detailed line-by-line statement to identify any errors, as over 80% of hospital bills contain mistakes that can be corrected through formal written disputes.