CMS Price Transparency Data

Blood test, sodium

Facility: Nemours Childrens Hospital, Florida

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84295
Insurance Median: $50
Cash Discount Price: $98
vs. Medicare Baseline: 10.40x Medicare

The contracted insurance negotiated median rate for a Blood test, sodium at Nemours Childrens Hospital, Florida is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $98. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 10.40x the Medicare baseline. Located in 6535 Nemours Pkwy, Orlando, FL.

Cash / Self-Pay

$98

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: $98 (2037%)

Insurance Median: $50 (1040%)

Cash: $98 (2037% 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.

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
Tricare	$4	83%
UnitedHealthcare	$4	83%
Cigna	$6 - $51	125%
Avmed	$21 - $39	437%
Truli	$25 - $51	520%
Employers Health Network Fl	$27 - $51	561%
Florida Blue	$27 - $77	561%
Aetna	$30 - $56	624%
Evolutions Healthcare	$31 - $57	644%
Integra Administrative Group	$41 - $76	852%
Global Medical Management	$44 - $83	915%
Prime Health Services	$44 - $83	915%
Star Healthcare Network	$44 - $83	915%
Velocity	$51 - $95	1060%
First Health Network	$53 - $99	1102%
Pnoa	$54 - $102	1123%
Seminole Tribe Of Fl	$54 - $102	1123%
Private Healthcare Systems	$63 - $117	1310%

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 $98.
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 Nemours Childrens Hospital, Florida 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.