CMS Price Transparency Data

Blood test, sodium

Facility: East Morgan County Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $27
  • Cash Discount Price: $23
  • vs. Medicare Baseline: 5.61x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at East Morgan County Hospital is $27. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 5.61x the Medicare baseline. Located in 2400 W Edison St, Brush, CO.
Cash / Self-Pay
$23

Average discount available for prompt cash payment at this facility.

Insurance Median
$27

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: $23 (478%)
Insurance Median: $27 (561%)
Cash: $23 (478% of Medicare)
Ins. Median: $27 (561% 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 561% of the Medicare baseline (a markup of 461%). 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
Aetna $13 - $42 270%
Banner Health $13 - $19 270%
Blue Cross Blue Shield $13 - $37 270%
Clear Spring Health $13 - $19 270%
Healthspring Life & Health Insurance Company, Inc. $13 - $19 270%
Medica $13 - $37 270%
Medicare (plans) $13 - $19 270%
Pinnacol Assurance Workers Comp $13 - $19 270%
Triwest Healthcare Alliance Corp - Va Ccn $13 - $19 270%
UnitedHealthcare $13 - $42 270%
Humana $14 - $21 291%
Longevity $14 - $20 291%
Devoted Health Services $15 - $21 312%
Assist Health Group $16 - $23 333%
Denver Health Medical Plan $25 - $36 520%
Apostrophe, Inc. $28 - $40 582%
First Choice Health Network $28 - $40 582%
Hue Health, Inc $29 - $43 603%
Rocky Mountain Health Plans $29 - $43 603%
Multiplan $30 - $44 624%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2400 W Edison St, Brush, CO 80723
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals