CMS Price Transparency Data

Blood test, sodium

Facility: Decatur County Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $42
  • Cash Discount Price: $42
  • vs. Medicare Baseline: 8.73x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Decatur County Hospital is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 8.73x the Medicare baseline. Located in 1405 Nw Church Street, Leon, IA.
Cash / Self-Pay
$42

Average discount available for prompt cash payment at this facility.

Insurance Median
$42

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: $42 (873%)
Insurance Median: $42 (873%)
Cash: $42 (873% of Medicare)
Ins. Median: $42 (873% 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 873% of the Medicare baseline (a markup of 773%). 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 $2 - $44 42%
Blue Cross Blue Shield $17 353%
Wellmark Hmo $20 416%
Champva -All Plans $23 478%
Wellmark Ppo - All Other Plans $23 478%
Everystep Hospice-All Plans $27 561%
Aetna $28 - $41 582%
Tricare $28 582%
Benefit Admin System-All Plans $34 707%
Humana $38 790%
Meritain Health-All Plans $38 790%
Misc Commercial-All Plans $38 790%
All Savers-All Plans $39 811%
Allied Benefit System-All Plans $39 811%
American Family Ins Grp-All Plans $39 811%
Rural Carrier Benefit Plan-All Plans $40 832%
Christian Healthcare -All Plans $42 873%
Medica-All Other Plans $42 873%
Golden Rule-All Plans $44 915%
Ntca The Rural Broadband-All Plans $44 915%
Cigna $45 936%
Medical Mutual-All Plans $46 956%
Farm Bureau Financial-All Other Plans $47 977%
Farm Bureau Property And Ca $47 977%
Medi Share-All Plans $47 977%
Uhss-All Plans $47 977%
Health Partners-All Plans $48 998%
Lewermark-All Plans $49 1019%
Mail Handlers Benefit-All Plans $51 1060%
Midlands Choice-All Plans $51 1060%
Priority Health-All Plans $52 1081%
Iowa Total Care Mcaid-All Plans $53 1102%
Amerigroup Mcaid-All Plans $55 1143%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1405 Nw Church Street, Leon, IA 50144
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals