CMS Price Transparency Data

Blood test, sodium

Facility: San Antonio Regional Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $18
  • Cash Discount Price: $185
  • vs. Medicare Baseline: 3.74x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at San Antonio Regional Hospital is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $185. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 3.74x the Medicare baseline. Located in 999 San Bernardino Road, Upland, CA.
Cash / Self-Pay
$185

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: $185 (3846%)
Insurance Median: $18 (374%)
Cash: $185 (3846% 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
Healthnet Medi-Cal $4 83%
Blue Cross Blue Shield $5 - $247 104%
Blue Shield Mcr Adv $5 104%
Caremore Mcr Adv - All Plans $5 104%
Choice Phycn Ntwrk Mcr Adv-All Other Plans $5 104%
Healthnet Mcr Adv $5 104%
Humana $5 104%
Iehp Mcr Adv $5 104%
Imperial Health Mcr Adv-All Plans $5 104%
Inter Valley Hp Mcr Adv- All Plans $5 104%
Kaiser Medi-Cal $5 104%
Kasiser Mcr Adv $5 104%
Kindred Mcr Adv-All Plans $5 104%
Medi-Cal $5 104%
Molina Mcr Adv $5 104%
Scan Health Plan Mcr Adv-All Plans $5 104%
Tricare $5 104%
Universal Care - All Plans $5 104%
Zelis Mcr Adv $5 104%
Aetna $6 - $455 125%
Alpha Care Mg Mcal/Hlthy Kids $6 125%
Choice Phycn Ntwrk Op Only $6 125%
Heritage Prov Ntwrk/Regal Mcal $6 125%
Molina Exchange-All Other Plans $6 125%
Molina Medi-Cal $6 125%
Iehp Comm - All Other Plans $7 146%
Iehp Mcal $7 146%
Redlands Employee $7 146%
Prime Health - All Plans $8 166%
Redlands Hmo-All Other Plans $8 166%
Healthnet - All Other Plans $12 249%
Blue Shield Epn $13 270%
Kaiser Comm - All Other Plans $13 270%
Cigna $18 374%
UnitedHealthcare $22 - $201 457%
Ambetter / Centene $83 1726%
Epic Health Plan - All Other Plans $136 2827%
Blue Shield Hmo Pos / Calpers Ppo $168 3493%
Blue Shield Epo Ppo - All Other Plans $183 3805%
Pc Inland Valley Scan $228 4740%
Pc Inland Valley-All Other Plans $228 4740%
Coventry Ccn/First Hlth - All Plans $250 5198%
Choicecare Ntwrk-All Plans $328 6819%
Multiplan/Phcs - All Plans $328 6819%
Networks By Design - All Plans $341 7089%
Zelis Comm-All Other Plans $341 7089%
Foundation Inland Epo-All Other Plans $364 7568%
Foundation Inland Ppo $387 8046%
Health Payors - All Plans $410 8524%
Interplan - All Plans $410 8524%
Wellcare/Easy Choice-All Plans $446 9272%
Alpha Care Mg Mcr Adv $455 9459%
Central Hlth Plan Mcr Adv-All Plans $455 9459%
Epic Health Plan Mcr Adv $455 9459%
Prospect Hp-All Plans $455 9459%
Providence Clevercare Mcr Adv $455 9459%
Heritage Prov Ntwrk/Regal Mcr Adv $462 9605%
Clever Care Mcr Adv - All Plans $478 9938%
La Salle Hp Mcr Adv-All Plans $478 9938%
Providence Oscar-All Other Plans $478 9938%
Alpha Care Mg-All Other Plans $569 11830%
Heritage Prov Ntwrk/Regal - All Other Plans $836 17380%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 999 San Bernardino Road, Upland, CA 91786
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals