CMS Price Transparency Data

Blood test, sodium

Facility: Grandview Medical Center

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $18
  • Cash Discount Price: $12
  • vs. Medicare Baseline: 3.74x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Grandview Medical Center is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 3.74x the Medicare baseline. Located in 3690 Grandview Parkway, Birmingham, AL.
Cash / Self-Pay
$12

Average discount available for prompt cash payment at this facility.

Insurance Median
$18

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$4.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.81 (100%)
Cash / Self-Pay: $12 (249%)
Insurance Median: $18 (374%)
Cash: $12 (249% of Medicare)
Ins. Median: $18 (374% of 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 374% of the Medicare baseline (a markup of 274%). 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medicaid / KanCare $3 62%
Bc Pml $4 83%
Node Champva $4 83%
Tricare $4 83%
UnitedHealthcare $4 - $27 83%
Aetna $5 - $6 104%
Blue Advantage $5 104%
Cigna $5 - $9 104%
Hospice $5 104%
Humana $5 104%
Medicare (plans) $5 104%
Node Clover Health Mcr Adv $5 104%
Node Devoted Health Mcr Adv $5 104%
Node Va $5 104%
Node Wellcare Mcr Adv $5 104%
Select Health $5 104%
Veterans Eval Services $5 104%
Victory Health $5 104%
Viva Health $5 - $34 104%
Node Us Dept Of Labor $6 125%
Ambetter / Centene $7 146%
Blue Cross Blue Shield $8 166%
Healthspring $8 166%
Self Pay $9 - $15 187%
Bp Health Advocate $15 312%
Ag Administrators $21 437%
Alamed $21 437%
Choicecare $21 437%
Drummond $21 437%
American Employee Alliance $24 499%
Healthchoice $30 - $37 624%
Value Options $30 624%
First Health $37 - $48 769%
Multiplan $37 - $43 769%
Blue Bell Creameries $43 894%
Natl Comp Care $46 956%
Usa Ppo $46 956%
Coventry Work Comp Al $48 998%
Novanet $49 1019%
Alabama Wc $52 1081%
Cal-Med $52 1081%
Corvel $52 1081%
Associated Admin $55 1143%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3690 Grandview Parkway, Birmingham, AL 35243
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals