Blood test, sodium
Facility: Regional Medical Center
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $870
- Cash Discount Price: $30
- vs. Medicare Baseline: 180.87x 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 18087% of the Medicare baseline (a markup of 17987%). 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 |
|---|---|---|
| Medical Associates Health Plan - Tri | $870 | 18087% |
Consumer Guidance & Cost Commentary
For patients paying cash, you should know that this specific blood test for sodium has a median cash rate of $30, which is significantly lower than the facility's gross charge of $38 and the negotiated rate of $870 paid by Medical Associates Health Plan - Tri. Because insurance contracts often include administrative overhead and multi-layered pricing structures, the cash price can sometimes be the most affordable option, especially for those with high-deductible plans where the insurer's allowed amount may exceed the cash rate. It is important to contact the facility directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront incentives can further reduce the final cost.
The broader rate context shows that while the cash price of $30 is very low, the median negotiated rate of $870 for this service is substantially higher, reflecting the typical markup found in commercial insurance contracts. This specific service code (84295) is associated with Regional Medical Center in Manchester, Iowa, a Critical Access Hospital owned by the Government - Local. Although the data does not provide explicit state or county averages for comparison, the stark difference between the $30 cash rate and the $870 insurance rate highlights the importance of verifying your payment method before scheduling. Federal protections under the No Surprises Act may apply if out-of-network providers are involved, but for this in-network service, the primary takeaway is that paying out-of-pocket at the cash rate avoids the significantly higher administrative costs embedded in the insurance negotiated rate.