CMS Price Transparency Data

Blood test, sodium

Facility: Greater El Monte Community Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $24
  • Cash Discount Price: $108
  • vs. Medicare Baseline: 4.99x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Greater El Monte Community Hospital is $24. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $108. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 4.99x the Medicare baseline. Located in 1701 Santa Anita Ave, South El Monte, CA.
Cash / Self-Pay
$108

Average discount available for prompt cash payment at this facility.

Insurance Median
$24

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: $108 (2245%)
Insurance Median: $24 (499%)
Cash: $108 (2245% of Medicare)
Ins. Median: $24 (499% 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 499% of the Medicare baseline (a markup of 399%). 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
Ahmc Reciprocity Agreement $2 - $41 42%
Ahmc Reciprocity Agreement Senior/Commercial $2 - $41 42%
Allied Physicians Medical Group $2 - $41 42%
Alta Med Health Services Med Grp $2 - $34 42%
Bella Vista Medical Group Ipa $2 - $62 42%
Employee Health Systems Medical Group $2 - $27 42%
Global Care Medical Group Ipa $2 - $62 42%
Good Samaritan Medical Practice Assoc $2 - $82 42%
Lincoln Hospital Medical Center $2 - $41 42%
Blue Cross Blue Shield $3 - $68 62%
Molina Healthcare Of California $3 - $53 62%
Veterans Administration $3 62%
Ahmc Healthcare Inc $4 83%
Aids Health Foundation $4 - $5 83%
Altamed Health Network $4 - $5 83%
Avanti $4 - $6 83%
Beverly Hospital $4 - $5 83%
Blue Shield Of California $4 - $68 83%
Brand New Day $4 - $6 83%
California Thoroughbred Horesmans Foundation $4 - $68 83%
Clinica Medica Familiar $4 - $68 83%
Emanate Health $4 - $6 83%
Health Net Foundation $4 - $89 83%
Healthy Way La $4 83%
La Care Health Plan $4 - $75 83%
Other Non Contracted Medi-Cal Hmo $4 83%
State Of California $4 83%
Universal Care $4 - $96 83%
Alignment Health Plan $5 104%
Allied Physicians $5 - $7 104%
Apa/Aco Inc $5 104%
Associated Hispanic Physicians $5 104%
Caloptima $5 104%
Care 1St Health Plan $5 - $82 104%
Champus Foundation $5 104%
Cms $5 104%
Cost Containment Strategies $5 - $89 104%
Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P $5 104%
Easy Choice Health Plan $5 104%
Health Net Inc $5 - $97 104%
Hollywood Presbyterian Adv Med Mcal $5 104%
Hollywood Presbyterian Medpoint Mcal $5 104%
In Custody Police Dept $5 - $89 104%
Inter Valley Health Plan $5 104%
Intercomp $5 104%
Interplan $5 - $103 104%
La Care Covered Direct $5 104%
Molina Healthcare $5 104%
Other Non Contracted Senior Hmo $5 104%
Pacific Alliance Medical Center Reciprocal Contract $5 104%
Pacificare Of California $5 - $119 104%
Preferred Health Network $5 104%
San Miguel Health Plan $5 104%
Scan Health Plan $5 104%
Self-Pay $5 104%
UnitedHealthcare $5 - $118 104%
Ahmc Health Self-Insurance Epo $6 125%
Athens Administrators $6 125%
Central Health Plan $6 - $96 125%
Chinatown Service Center Pace $6 125%
Cigna $6 125%
Community Care Network $6 - $110 125%
Knox-Keene Act $6 125%
Multiplan $6 - $116 125%
Other Non Contracted Work Comp $6 125%
Health Payors Organization $7 - $123 146%
Commercial Non Contract $8 - $137 166%
Medi-Cal Sub Acute $8 - $137 166%
Nuclear Medicine/Whmc $8 - $137 166%
One Legacy $8 - $137 166%
Care 1St Medi Cal Hmo Cap Exceptional Care $10 - $14 208%
Care First Health Plan $10 - $14 208%
In Custody-Ca Highway Patrol $20 416%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1701 Santa Anita Ave, South El Monte, CA 91733
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals