CMS Price Transparency Data

Blood test, sodium

Facility: San Gabriel Valley Medical Center

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $6
  • Cash Discount Price: $116
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at San Gabriel Valley Medical Center is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $116. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 1.25x the Medicare baseline. Located in 438 W Las Tunas Drive, San Gabriel, CA.
Cash / Self-Pay
$116

Average discount available for prompt cash payment at this facility.

Insurance Median
$6

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: $116 (2412%)
Insurance Median: $6 (125%)
Cash: $116 (2412% of Medicare)
Ins. Median: $6 (125% 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.

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
Veterans Administration $3 62%
Ahmc Medi-Cal Reciprocity $4 83%
Allied Physicians $4 - $7 83%
Altamed Health Network $4 - $5 83%
Beverly Hospital $4 - $5 83%
Blue Cross Blue Shield $4 - $23 83%
Brand New Day $4 - $135 83%
Emanate Health $4 - $6 83%
Healthnet Medi-Cal Non-Contract $4 83%
Healthy Way La $4 83%
La Care Health Plan $4 - $5 83%
Non Contracting Medi Cal $4 83%
Aetna $5 - $8 104%
Aids Healthcare Foundation $5 - $154 104%
Alignment Health Plan $5 104%
Apa/Aco Inc $5 104%
Avanti $5 - $6 104%
Blue Shield Of California $5 - $68 104%
Care 1St Health Plan $5 - $251 104%
Central Health Plan $5 - $232 104%
Cv-19 Hrsa Uninsured Testing And Tx $5 104%
Health Net $5 - $224 104%
Health Net Inc $5 - $11 104%
Hollywood Presbyterian Adv Med Mcal $5 104%
Hollywood Presbyterian Medpoint Mcal $5 104%
Humana $5 104%
Inter Valley Health Plan $5 104%
Medicaid / KanCare $5 104%
Medicare (plans) $5 104%
Molina Healthcare Of California $5 - $151 104%
Pacific Alliance Medical Center $5 104%
Pacificare Of California $5 - $126 104%
Physicians Healthways $5 104%
Providence Health Network $5 104%
Self-Pay $5 104%
St Vincent Medical Center/Psych $5 104%
Tricare $5 104%
Wellcare $5 104%
Ahmc Health Self-Insurance Epo $6 125%
Athens Administrators $6 125%
Beech Street $6 - $309 125%
Chinatown Service Center Pace $6 125%
Cigna $6 125%
Knox-Keene Act $6 125%
Other Non Contracting Workers Comp $6 125%
UnitedHealthcare $10 - $19 208%
Private Pay $14 291%
Ahmc Reciprocity $116 2412%
Alignment Healthplan $135 2807%
Clever Care $135 2807%
Pacific Independent Physician Associates $154 3202%
Facey Medical $193 4012%
Community Care Network $251 5218%
Choicecare Network $270 5613%
Private Healthcare Systems (Phcs) $270 5613%
Affiliated Health Fund $290 6029%
Multiplan $347 7214%
Ppo Next $347 7214%
Managed Health Network $386 8025%
Medi-Cal Sub Acute $386 8025%
One Legacy $386 8025%
Other Non Contracted Commercial $386 8025%
Us Behavioral Health Plan $386 8025%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 438 W Las Tunas Drive, San Gabriel, CA 91776
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals