CMS Price Transparency Data

Blood test, sodium

Facility: Boone County Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $11
  • Cash Discount Price: $16
  • vs. Medicare Baseline: 2.29x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Boone County Hospital is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 2.29x the Medicare baseline. Located in 1015 Union Street, Boone, IA.
Cash / Self-Pay
$16

Average discount available for prompt cash payment at this facility.

Insurance Median
$11

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: $16 (333%)
Insurance Median: $11 (229%)
Cash: $16 (333% of Medicare)
Ins. Median: $11 (229% 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 229% of the Medicare baseline (a markup of 129%). 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
Va Ccn-All Plans $2 42%
Aetna $3 - $26 62%
Amerigroup Mcr Adv - All Other Plans $3 - $14 62%
Choice Care Mcr Adv - All Plans $3 - $14 62%
Humana $3 - $30 62%
Iowa Hlth Adv - All Plans $3 - $14 62%
Mt Carmel Hp - All Plans $3 - $14 62%
UnitedHealthcare $3 - $19 62%
Iowa Total Care Mcaid - All Plans $4 - $15 83%
Medicaid / KanCare $4 - $15 83%
Meridian Mcaid - All Plans $4 - $15 83%
Tricare $5 104%
Healthsmart Accell Network $6 - $23 125%
Healthsmart Ppo - All Other Plans $6 - $27 125%
Medical Associates Hp-All Plans $6 - $25 125%
Health Alliance-All Plans $7 - $30 146%
Midlands Choice-All Plans $7 - $31 146%
Mutually Preferred-All Plans $8 - $32 166%
Wellmark Hmo $23 478%
Wellmark Ppo - All Other Plans $25 520%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1015 Union Street, Boone, IA 50036
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals