Blood test, sodium
Facility: Northeast Regional Medical Center
Billing Code: 84295 (CPT)
- CPT Billing Code: 84295
- Insurance Median: $91
- Cash Discount Price: $101
- vs. Medicare Baseline: 18.92x 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 1892% of the Medicare baseline (a markup of 1792%). 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 |
|---|---|---|
| Tricare | $4 | 83% |
| Medicaid / KanCare | $4 - $7 | 83% |
| Node Champva | $4 | 83% |
| Node VA | $5 | 104% |
| UnitedHealthcare | $5 - $192 | 104% |
| Blue Pathway/Pathway X | $5 | 104% |
| Medicare (plans) | $5 | 104% |
| Node Devoted Health McR Adv | $5 | 104% |
| Veterans Eval Services | $5 | 104% |
| Blue Access | $5 | 104% |
| Blue Prefrerred | $5 | 104% |
| Node Hospice Non Par Agree | $5 | 104% |
| Blue Cross Blue Shield | $5 - $78 | 104% |
| Us Department of Labor | $6 | 125% |
| Centurion Correctional | $6 | 125% |
| Home State Exchange | $9 | 187% |
| Naphcare | $9 | 187% |
| Immergrun | $10 | 208% |
| Self Pay | $62 - $141 | 1289% |
| Cigna | $87 - $100 | 1809% |
| Aetna | $95 - $214 | 1975% |
| Access Health Services, LLC | $167 | 3472% |
| Healthlink | $192 - $205 | 3992% |
| Multiplan | $192 - $205 | 3992% |
| Coventry Wc | $205 | 4262% |
Consumer Guidance & Cost Commentary
For the CPT code 84295 (Blood test, sodium) at Northeast Regional Medical Center in Kirksville, MO, the cash median rate is $101, which is significantly lower than the facility's gross charge of $257. While the facility's negotiated rates range from $4 to $78 depending on the specific insurance plan, the cash price remains the lowest fixed amount available for this procedure. This scenario highlights a common pricing dynamic where paying out-of-pocket can be more cost-effective than using insurance, particularly if your plan has a high deductible or if the negotiated rate exceeds the cash price.
Patients should be aware that commercial insurance rates for this service can vary widely, with the highest negotiated rate recorded at $214 for Aetna and the lowest at $4 for Medicaid/KanCare. Since the cash median of $101 is well below the majority of these negotiated figures, individuals with high-deductible plans may save money by paying directly. To ensure you receive the best possible rate, it is advisable to contact the hospital directly to confirm if additional "self-pay" or "prompt-pay" discounts are available before scheduling your appointment.