CMS Price Transparency Data

Blood test, sodium

Facility: Sonoma Valley Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $34
  • Cash Discount Price: $117
  • vs. Medicare Baseline: 7.07x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Sonoma Valley Hospital is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $117. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 7.07x the Medicare baseline. Located in 347 Andrieux St, Sonoma, CA.
Cash / Self-Pay
$117

Average discount available for prompt cash payment at this facility.

Insurance Median
$34

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: $117 (2432%)
Insurance Median: $34 (707%)
Cash: $117 (2432% of Medicare)
Ins. Median: $34 (707% 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 707% of the Medicare baseline (a markup of 607%). 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.

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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 - $167 104%
Bright Hlth/Brand New Day Mcr Adv $5 104%
Hospice Of Marin-All Plans $5 104%
Marin General Comm/Mcr Adv (Western Hlth)-All Plan $5 104%
Medi-Cal $5 104%
Partnership Healthplan-All Plans $5 104%
St Joseph Heritage Hltcare Comm-All Other Plans $5 104%
Tricare $5 104%
Veterans Admin-All Plans $5 104%
Bright Hlth/Brand New Day - All Other Plands $6 125%
Cdcr Prison-All Plans $6 125%
Chp - Correctional Health Partners - All Plans $6 125%
Three Rivers (Trpn)-All Plans $6 125%
Wellpath - All Plans $7 146%
Aetna $8 166%
First Health(Coventry)-All Plans $8 166%
Mcal Mgd Care (Php)-All Plans $8 166%
Meritage Medical Network Op Only Mcare $8 166%
Meritage Medical Network Op Only-All Other Plans $8 166%
Canopy Bay Area Accountable Care Ntwrk (Baacn) - A $9 187%
Canopy Health Solutions-All Other Plans $9 187%
UnitedHealthcare $10 208%
Healthnet Hmo/Ppo-All Other Plans $58 1206%
Blue Shield Ppo-All Plans $95 1975%
Kaiser-All Plans $109 2266%
Integrated Health Plan-All Plans $124 2578%
Champus-All Plans $134 2786%
Cigna $134 2786%
Networks By Design - All Plans $134 2786%
Comm Care Network(Ccn)-All Plans $142 2952%
Great West-One Health Plan Ppo/Pos-All Plans $142 2952%
Phcs/Multiplan/Beech St-All Plans $142 2952%
Interplan-All Plans $147 3056%
Bps-All Plans $150 3119%
Ppo Alliance-All Plans $150 3119%
Pref Health Networl(Phn)-All Plans $150 3119%
Scan Mcare-All Plans $167 3472%
St Joseph Heritage Hltcare Mcr Adv $167 3472%
Correct Care Integ Health-All Plans $200 4158%
Employer Direct Healthcare-All Plans $200 4158%
Creative Legal Services-All Plans $217 4511%
Canopy Op Only $301 6258%
Vnpn - All Plans $301 6258%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 347 Andrieux St, Sonoma, CA 95476
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals