CMS Price Transparency Data

Blood test, sodium

Facility: Mercyone Elkader Medical Center

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $45
  • Cash Discount Price: $40
  • vs. Medicare Baseline: 9.36x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Mercyone Elkader Medical Center is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 9.36x the Medicare baseline. Located in 901 Davidson Street Nw, Elkader, IA.
Cash / Self-Pay
$40

Average discount available for prompt cash payment at this facility.

Insurance Median
$45

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: $40 (832%)
Insurance Median: $45 (936%)
Cash: $40 (832% of Medicare)
Ins. Median: $45 (936% 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 936% of the Medicare baseline (a markup of 836%). 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
Blue Cross Blue Shield $31 644%
Aetna $32 - $45 665%
Medicare (plans) $32 - $33 665%
UnitedHealthcare $34 - $46 707%
Iowa Total Care $38 790%
Medicaid / KanCare $39 811%
Amish Hospital Aid $42 873%
1199 National Benefit Fund $45 936%
Allied Benefit Systems $45 936%
Asr Health Benefits $45 936%
Christian Brother Services $45 936%
Coventry $45 936%
First Health $45 936%
Lucent Health $45 936%
Luminare Health $45 936%
Medical Mutual $45 936%
Meritain $45 936%
Trustmark Small Business Benefits $45 936%
Webtpa $45 936%
Geha $46 956%
Centivo $48 998%
Health Choices $49 1019%
Medical Associates $49 1019%
Ambetter / Centene $53 1102%
Health Partners $59 1227%
Auxiant $60 1247%
Cigna $60 1247%
Medica $60 1247%
Midlands $60 1247%
Midlands Choice $60 1247%
Crime Victim Assistance $61 1268%
Iowa Dept Of Public Health $61 1268%
Claimdoc $64 1331%
Nova $64 1331%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 Davidson Street Nw, Elkader, IA 52043
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals