CMS Price Transparency Data

Blood test, sodium

Facility: City of Hope National Medical Center

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84295
Insurance Median: $55
Cash Discount Price: $69
vs. Medicare Baseline: 11.43x Medicare

The contracted insurance negotiated median rate for a Blood test, sodium at City of Hope National Medical Center is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 11.43x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.

Cash / Self-Pay

$69

Average discount available for prompt cash payment at this facility.

Insurance Median

$55

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: $69 (1435%)

Insurance Median: $55 (1143%)

Cash: $69 (1435% of Medicare)

Ins. Median: $55 (1143% 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 1143% of the Medicare baseline (a markup of 1043%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Health Net	$3 - $68	62%
Cal Optima	$4 - $5	83%
Heritage Provider Network	$4 - $49	83%
Facey	$6	125%
Inland Empire	$6 - $56	125%
Prime Healthcare Keenan	$8 - $67	166%
UnitedHealthcare	$14 - $39	291%
Blue Cross Blue Shield	$34 - $49	707%
Blue Shield	$40 - $91	832%
Blue Shield Covca	$42 - $43	873%
Blue Shield Promise	$48 - $49	998%
Cencal	$55 - $56	1143%
La Care Health	$55 - $56	1143%
Kaiser	$61 - $63	1268%
Aetna	$68 - $70	1414%
Gold Coast	$68 - $70	1414%
Molina	$68 - $91	1414%
Cigna	$73 - $76	1518%
Healthcare Partners	$79 - $82	1642%
St. Joseph Heritage	$82 - $84	1705%
Primecare Medical Network	$89 - $91	1850%
First Health	$105 - $108	2183%
Phcs Multiplan	$123 - $127	2557%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $69.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84295.

Insurance In-Network Protection Plan

Contact your insurance company to confirm City of Hope National Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 84295.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.