CMS Price Transparency Data

Blood test, sodium

Facility: Doctors Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $32
  • Cash Discount Price: $55
  • vs. Medicare Baseline: 6.65x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Doctors Hospital is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $55. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 6.65x the Medicare baseline. Located in 5000 University Dr, Coral Gables, FL.
Cash / Self-Pay
$55

Average discount available for prompt cash payment at this facility.

Insurance Median
$32

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: $55 (1143%)
Insurance Median: $32 (665%)
Cash: $55 (1143% of Medicare)
Ins. Median: $32 (665% 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 665% of the Medicare baseline (a markup of 565%). 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 $3 - $67 62%
Amerigroup $3 62%
Medicaid / KanCare $3 62%
Sunshine State $3 62%
UnitedHealthcare $3 - $84 62%
Vista $3 62%
Wellcare $3 62%
Avmed $5 - $42 104%
Blue Cross Blue Shield $5 - $54 104%
Cigna $5 - $67 104%
Humana $5 104%
Leon Medical $5 104%
Medica Health Plan $5 104%
Medicare (plans) $5 - $6 104%
Non Contracted $31 644%
Amerihealth $38 790%
International $55 1143%
Dimension Health Plan $63 - $76 1310%
Affordable $71 1476%
Phcs $76 1580%
Quality Health $76 1580%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5000 University Dr, Coral Gables, FL 33146
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals