CMS Price Transparency Data

Blood test, sodium

Facility: Adventist Health Howard Memorial

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84295
Insurance Median: $100
Cash Discount Price: $50
vs. Medicare Baseline: 20.79x Medicare

The contracted insurance negotiated median rate for a Blood test, sodium at Adventist Health Howard Memorial is $100. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 20.79x the Medicare baseline. Located in 1 Marcela Dr, Willits, CA.

Cash / Self-Pay

$50

Average discount available for prompt cash payment at this facility.

Insurance Median

$100

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: $50 (1040%)

Insurance Median: $100 (2079%)

Cash: $50 (1040% of Medicare)

Ins. Median: $100 (2079% 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 2079% of the Medicare baseline (a markup of 1979%). 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
Medi-Cal	$5	104%
Blue Shield Mcare	$24 - $46	499%
Tricare	$24 - $46	499%
Medicare (plans)	$25 - $47	520%
UnitedHealthcare	$27 - $179	561%
Blue Cross Blue Shield	$48 - $57	998%
Ah Employee Health Plan - All Plans	$63 - $120	1310%
Aetna	$82 - $155	1705%
Blue Shield Epn	$83 - $158	1726%
Blue Shield - All Other Plans	$84 - $158	1746%
Western Growers/Pinnacle - All Plans	$92 - $173	1913%
First Health Ppo - All Plans	$98 - $185	2037%
Ghn Ppo - All Plans	$98 - $185	2037%
Healthnet - All Plans	$100 - $189	2079%
Brms - All Plans	$104 - $196	2162%
Cigna	$104 - $196	2162%

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 $50.
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 Adventist Health Howard Memorial 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.