CMS Price Transparency Data

Blood test, sodium

Facility: UW Health

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84295
Insurance Median: $46
Cash Discount Price: $18
vs. Medicare Baseline: 9.56x Medicare

The contracted insurance negotiated median rate for a Blood test, sodium at UW Health is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 9.56x the Medicare baseline. Located in 1401 East State Street, Rockford, IL.

Cash / Self-Pay

$18

Average discount available for prompt cash payment at this facility.

Insurance Median

$46

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: $18 (374%)

Insurance Median: $46 (956%)

Cash: $18 (374% of Medicare)

Ins. Median: $46 (956% 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 956% of the Medicare baseline (a markup of 856%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$5 - $55	104%
Blue Cross Blue Shield	$5 - $38	104%
Humana	$5	104%
Medicare (plans)	$5	104%
Mychoice Wi Medical Adv	$5	104%
UnitedHealthcare	$5 - $8	104%
Quartz Fully Insured	$6	125%
Ecoh	$35 - $60	728%
Hfn	$35 - $60	728%
Alliance Premier Network	$38 - $42	790%
Quartz Aso	$38 - $42	790%
The Alliance	$49 - $54	1019%
Wps Ppo	$54 - $59	1123%
Cigna	$55 - $61	1143%
Beloit Healt System	$63 - $69	1310%
Mercycare	$65 - $71	1351%
First Health/Coventry	$68 - $75	1414%
Health Payment Systems	$81 - $89	1684%
Healthsmart	$81 - $89	1684%
Sheboygan Employers Health Network	$86 - $95	1788%
Multiplan	$97 - $106	2017%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $18.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84295.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UW Health is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 84295.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.