CMS Price Transparency Data

Blood test, sodium

Facility: Jefferson County Health Center

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $25
  • Cash Discount Price: $35
  • vs. Medicare Baseline: 5.20x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Jefferson County Health Center is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 5.20x the Medicare baseline. Located in 2000 S Main, Fairfield, IA.
Cash / Self-Pay
$35

Average discount available for prompt cash payment at this facility.

Insurance Median
$25

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: $35 (728%)
Insurance Median: $25 (520%)
Cash: $35 (728% of Medicare)
Ins. Median: $25 (520% 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 520% of the Medicare baseline (a markup of 420%). 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 - $52 62%
Tricare $22 457%
Amerigroup Mcr Adv $23 478%
Humana $23 478%
Iowa Total Care Comm - All Other Plans $23 478%
Iowa Total Care Mcr $23 478%
Molina Mcr Adv $23 478%
Wellmark Hmo $23 478%
Iowa Total Care Mcaid $24 499%
Molina Mcaid/Chip $24 499%
Medicaid / KanCare $25 520%
Wellmark Indemnity/Ppo - All Other Plans $26 541%
Aetna $28 - $52 582%
Medicare (plans) $28 582%
Midlands New Product $48 998%
Coventry Commercial Hmo $49 1019%
Coventry Commercial Ppo - All Other Plans $52 1081%
Midlands Choice-All Other Plans $52 1081%
Molina Marketplace - All Other Plans $58 1206%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 S Main, Fairfield, IA 52556
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals