CMS Price Transparency Data

Blood test, sodium

Facility: Valley Children's Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $37
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 7.69x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Valley Children's Hospital is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 7.69x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$37

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%)
Insurance Median: $37 (769%)
Ins. Median: $37 (769% 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 769% of the Medicare baseline (a markup of 669%). 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
Allcare Ipa $7 146%
Central California Alliance For Health $9 187%
Central Valley Medical Providers Ipa $10 - $33 208%
Dignity Ipa_Formerly Img $10 208%
Kaiser $10 - $43 208%
La Salle Ipa $10 208%
Sante Ipa $10 208%
Sequoia Health Ipa $10 208%
Univseral Healthcare Ipa $10 208%
Community Care Ipa $11 229%
United Physicians Network Ipa $11 229%
Adventist $12 249%
Blue Cross Blue Shield $12 - $48 249%
Cencal Health $13 270%
Kern Family Health Care $14 291%
Health Net $23 - $43 478%
Dignity Health Central Coast $33 686%
Community Health $36 748%
Stanislaus Partners In Health $36 748%
Physicians Choice Medical Group $37 769%
Health Plan Of San Joaquin $40 832%
Fowler Packing $41 852%
Dignity (Formerly Managed Care Systems) $42 873%
Kern Legacy $43 894%
Aetna $44 915%
Blue Shield $44 - $50 915%
First Health Formerly Coventry $49 1019%
Bakersfield Family Medical Group $50 1040%
Network By Design $51 1060%
Community Care Health Plan $53 1102%
Health Smart $53 1102%
Key Medical Ipa $53 1102%
Sutter Health $56 1164%
Multiplan $63 1310%
UnitedHealthcare $81 1684%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens