CMS Price Transparency Data

Blood test, sodium

Facility: HSHS St Elizabeth's Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $65
  • Cash Discount Price: $59
  • vs. Medicare Baseline: 13.51x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at HSHS St Elizabeth's Hospital is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 13.51x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$59

Average discount available for prompt cash payment at this facility.

Insurance Median
$65

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: $59 (1227%)
Insurance Median: $65 (1351%)
Cash: $59 (1227% of Medicare)
Ins. Median: $65 (1351% 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 1351% of the Medicare baseline (a markup of 1251%). 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
Meridian Health Plan $4 83%
Molina Healthcare $4 - $5 83%
Aetna $5 - $58 104%
Blue Cross Blue Shield $5 - $82 104%
Clear Spring Health Of Illinois $5 104%
Health Alliance Medical Plans $5 - $70 104%
Health Partners $5 104%
Humana $5 104%
Sae Hospice $5 104%
UnitedHealthcare $5 - $82 104%
Celtic Insurance Company $10 208%
Naphcare $11 229%
Claim Doc $12 249%
Hopetrust $12 249%
Amish Community $23 478%
Wellfirst $53 1102%
First Health $61 1268%
Cigna $65 - $82 1351%
Healthlink $65 - $82 1351%
Caterpillar, Inc. $66 1372%
Consociate Group $72 1497%
Choicecare $74 1538%
Healthcare Finest Network (Hfn) $74 1538%
Multiplan/Phcs $74 1538%
Provider Network Of America $74 1538%
City Of Springfield $82 1705%
Current Health Solutions $82 1705%
Healthscope $82 1705%
Illinois Breast And Cervical Cancer Program $82 1705%
Interplan $82 1705%
Live360 $82 1705%
Wexford $82 1705%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals