CMS Price Transparency Data

Blood test, sodium

Facility: Franklin General Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $24
  • Cash Discount Price: $52
  • vs. Medicare Baseline: 4.99x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Franklin General Hospital is $24. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $52. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 4.99x the Medicare baseline. Located in 1720 Central Avenue East, Hampton, IA.
Cash / Self-Pay
$52

Average discount available for prompt cash payment at this facility.

Insurance Median
$24

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: $52 (1081%)
Insurance Median: $24 (499%)
Cash: $52 (1081% of Medicare)
Ins. Median: $24 (499% 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 499% of the Medicare baseline (a markup of 399%). 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
UnitedHealthcare $3 - $48 62%
Wellmark Hmo $20 416%
Amerigroup Mcare $23 478%
Medical Associates Mcare $23 478%
Mount Carmel Hp-All Plans $23 478%
Tricare $23 478%
Wellmark Mcr Adv $23 478%
Wellmark Ppo - All Other Plans $23 478%
Ambetter / Centene $24 - $37 499%
American Hp Iowa - All Plans $24 499%
Amerigroup Mcaid - All Other Plans $24 499%
Molina Mcare $24 499%
Molina Mcaid - All Other Plans $25 520%
Centivo - All Plans $35 728%
Medical Ass Hosp Employer Group $35 728%
Oscar - All Plans $35 728%
Midlands Choice-All Plans $41 852%
Medical Associates Hp-All Other Plans $49 1019%
Preferred Health Choices-All Plans $49 1019%
Splashlight Llc-All Plans $49 1019%
Aetna $54 - $55 1123%
Multiplan-All Plans $55 1143%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1720 Central Avenue East, Hampton, IA 50441
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals