CMS Price Transparency Data
Blood test, sodium
Facility: Watsonville Community Hospital
Billing Code: 84295 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 84295
- Insurance Median: $593
- Cash Discount Price: $595
- vs. Medicare Baseline: 123.28x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Watsonville Community Hospital is $593. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $595. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 123.28x the Medicare baseline. Located in 75 Nielson Street, Watsonville, CA.
Cash / Self-Pay
$595
Average discount available for prompt cash payment at this facility.
Insurance Median
$593
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: $595 (12370%)
Insurance Median: $593 (12328%)
Cash: $595 (12370% of Medicare)
Ins. Median: $593 (12328% 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 12328% of the Medicare baseline (a markup of 12228%). 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 |
|---|---|---|
| Ace-Usa | $5 | 104% |
| Alignment Health Plan | $5 | 104% |
| Alliance/Sccho | $5 | 104% |
| Beta Healthcare Group | $5 | 104% |
| Blue Shield Ppo | $5 - $15 | 104% |
| California Childrens Srvs | $5 | 104% |
| Ccs/Monterey County | $5 | 104% |
| Crawford & Co | $5 | 104% |
| Fireman'S Fund Work Comp | $5 | 104% |
| Fleming & Associates | $5 | 104% |
| Gallagher Bassett Svcs | $5 | 104% |
| Hartford Workers' Comp | $5 | 104% |
| Health Net Of California | $5 - $622 | 104% |
| Healthy Families | $5 - $15 | 104% |
| Keenan & Assoc Work Comp | $5 | 104% |
| Kemper Group Workers Comp | $5 | 104% |
| Liberty Mutual Work Comp | $5 | 104% |
| Medi-Cal E.R. | $5 | 104% |
| Medi-Cal/Eds | $5 | 104% |
| Medicaid / KanCare | $5 | 104% |
| Medicare (plans) | $5 | 104% |
| Miscellaneous Work Comp | $5 | 104% |
| Nx Health Network | $5 | 104% |
| Pinnacle Healthcare Uc | $5 | 104% |
| Republic Idemnity W/Comp | $5 | 104% |
| Secure Horizons | $5 | 104% |
| Secure Horizons Dign Hmo | $5 - $198 | 104% |
| Travelers Insurance | $5 - $992 | 104% |
| Tricare | $5 | 104% |
| U.S. Dept. Of Labor | $5 | 104% |
| UnitedHealthcare | $5 - $595 | 104% |
| Veterans Administration | $5 | 104% |
| Well Path | $5 - $992 | 104% |
| Western Growers Work Comp | $5 | 104% |
| Workers Comp | $5 | 104% |
| Bs Employee | $15 | 312% |
| Ufcw/Valley Clerks | $15 | 312% |
| United Agriculture | $15 | 312% |
| Blue Cross Blue Shield | $32 - $883 | 665% |
| Calif Ironworkers Field | $32 - $883 | 665% |
| Carpenters H&W Trust | $32 - $883 | 665% |
| City Of Wats/Pinnacle Clm | $32 - $883 | 665% |
| Claims Management Wc | $32 - $883 | 665% |
| Delta Health Systems | $32 - $883 | 665% |
| Laborers Health & Welfare | $32 - $883 | 665% |
| Monterey Bay Pub Emp Trst | $32 - $883 | 665% |
| Operating Engineers | $32 - $883 | 665% |
| Pinnacle Claims Tpa/Bc | $32 - $883 | 665% |
| Robert Kennedy/Ccn | $32 - $883 | 665% |
| Sheet Metal Workers | $32 - $883 | 665% |
| State Compensation Fund | $32 - $883 | 665% |
| Teamsters Benefit Trust | $32 - $883 | 665% |
| Western Growers Trust/Bc | $32 - $883 | 665% |
| Medicruz | $178 | 3701% |
| Victim Compensation Plan | $178 - $992 | 3701% |
| Aetna | $198 - $813 | 4116% |
| Blue Shield Hmo | $198 | 4116% |
| Cigna | $198 - $694 | 4116% |
| Great-West/Phcs | $198 - $694 | 4116% |
| Health Net Pmg Hmo | $198 - $622 | 4116% |
| Pacificare Hmo | $198 - $595 | 4116% |
| Western Health Advantage | $496 | 10312% |
| Health Net Smartcare Netw | $595 | 12370% |
| Pacificare Ppo | $595 | 12370% |
| Self Pay | $595 | 12370% |
| Health Net Blue And Gold | $622 | 12931% |
| Health Net Canopycare Hmo | $622 | 12931% |
| Adventist Risk Management | $694 - $793 | 14428% |
| First Health | $694 - $793 | 14428% |
| Geha (Ccn) | $694 - $793 | 14428% |
| Transwestern | $694 - $793 | 14428% |
| Multiplan Inc Ppo | $773 | 16071% |
| Private Healthcare System | $773 | 16071% |
| Coastal Healthcare Admin | $843 - $892 | 17526% |
| Salinas Valley Mem Hops | $843 | 17526% |
| Aaa | $992 | 20624% |
| Aarp | $992 | 20624% |
| Allstate | $992 | 20624% |
| Apwu Health Plan | $992 | 20624% |
| Bankers Life & Casualty | $992 | 20624% |
| Farmers Insurance | $992 | 20624% |
| Humana | $992 | 20624% |
| Miscellaneous Auto | $992 | 20624% |
| Miscellaneous Insurance | $992 | 20624% |
| North Calif Bakery Driver | $992 | 20624% |
| Physicians Mutual | $992 | 20624% |
| Prucare Pmg Hmo | $992 | 20624% |
| Prucare Pmg Pos | $992 | 20624% |
| State Farm Ins | $992 | 20624% |
| Sutter Health Plus | $992 | 20624% |
| United Administrative | $992 | 20624% |
| Wholesale Beer Distributo | $992 | 20624% |
| Zenith National Ins | $992 | 20624% |