CMS Price Transparency Data

Blood test, sodium

Facility: Mercyone Des Moines Medical Center

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $75
  • Cash Discount Price: $21,744
  • vs. Medicare Baseline: 15.59x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Mercyone Des Moines Medical Center is $75. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21,744. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 15.59x the Medicare baseline. Located in 1111 6Th Ave, Des Moines, IA.
Cash / Self-Pay
$21,744

Average discount available for prompt cash payment at this facility.

Insurance Median
$75

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: $21,744 (452058%)
Insurance Median: $75 (1559%)
Cash: $21,744 (452058% of Medicare)
Ins. Median: $75 (1559% 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 1559% of the Medicare baseline (a markup of 1459%). 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 $5 - $12,153 104%
Blue Cross Blue Shield $5 - $13,117 104%
Geha $5 104%
Iowa Total Care $5 - $12,118 104%
Medicaid / KanCare $5 - $12,285 104%
Medicare (plans) $5 - $12,649 104%
UnitedHealthcare $5 - $12,396 104%
Amish Hospital Aid $6 - $16,493 125%
Centivo $7 - $17,894 146%
Oscar $7 - $17,621 146%
Ambetter / Centene $8 - $20,833 166%
Iowa Dept Of Public Health $9 - $118 187%
Claimdoc $10 - $24,925 208%
Nova $10 - $24,925 208%
Health Choices $24 499%
Medical Associates $24 499%
1199 National Benefit Fund $41 852%
Allied Benefit Systems $41 852%
Asr Health Benefits $41 852%
Christian Brother Services $41 852%
Coventry $41 852%
First Health $41 852%
Lucent Health $41 852%
Luminare Health $41 852%
Medical Mutual $41 852%
Meritain $41 852%
Trustmark Small Business Benefits $41 852%
Webtpa $41 852%
Cigna $71 1476%
Health Partners $75 1559%
Auxiant $77 1601%
Medica $77 1601%
Midlands $77 1601%
Midlands Choice $77 1601%
Usa Managed Care $100 2079%
Crime Victim Assistance $118 2453%
Blue Benefit Administrators Of Massachusetts $13,117 272703%
Blue Care Network $13,117 272703%
Blue Distinction Transplant $13,117 272703%
Blue Shield - Ca $13,117 272703%
Blue Shield - Id (Regence) $13,117 272703%
Blue Shield - Ny Highmark Northeastern $13,117 272703%
Blue Shield - Ny Highmark Western $13,117 272703%
Blue Shield - Pa (Highmark) $13,117 272703%
Blue Shield - Wa (Regence) $13,117 272703%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1111 6Th Ave, Des Moines, IA 50314
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals