CMS Price Transparency Data

Blood test, sodium

Facility: Adventist Health Clearlake

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $50
  • Cash Discount Price: $44
  • vs. Medicare Baseline: 10.40x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Adventist Health Clearlake is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 10.40x the Medicare baseline. Located in 15630 18Th Ave - Hwy 53, Clearlake, CA.
Cash / Self-Pay
$44

Average discount available for prompt cash payment at this facility.

Insurance Median
$50

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: $44 (915%)
Insurance Median: $50 (1040%)
Cash: $44 (915% of Medicare)
Ins. Median: $50 (1040% 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 1040% of the Medicare baseline (a markup of 940%). 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
Ah Employee Health Plan - All Plans $1 - $93 21%
Aetna $3 - $166 62%
Blue Shield Epn - All Other Plans $3 - $170 62%
Blue Shield Non-Epn $3 - $170 62%
Cigna $3 - $200 62%
First Health- All Plans $3 - $178 62%
Foundation- All Plans $3 - $189 62%
Health Mgmt Network- All Plans $3 - $189 62%
Healthnet- All Plans $3 - $182 62%
Humana $3 - $189 62%
Interplan- All Plans $3 - $200 62%
Kaiser- All Other Plans $3 - $200 62%
Phcs- All Plans $3 - $189 62%
Three Rivers Provider Network- All Plans $3 - $200 62%
UnitedHealthcare $3 - $185 62%
Western Growers- All Plans $3 - $166 62%
Bc Managed Mcal $4 - $5 83%
Medi-Cal $4 - $5 83%
Partnership Mcal - All Plans $4 - $5 83%
Blue Shield Mcr Adv $26 - $47 541%
Kaiser Mcr Adv $26 - $47 541%
Tricare $26 - $47 541%
Blue Cross Blue Shield $27 - $56 561%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15630 18Th Ave - Hwy 53, Clearlake, CA 95422
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals