CMS Price Transparency Data

Blood test, sodium

Facility: Northwestern Medicine Central Dupage Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84295
Insurance Median: $44
Cash Discount Price: $52
vs. Medicare Baseline: 9.15x Medicare

The contracted insurance negotiated median rate for a Blood test, sodium at Northwestern Medicine Central Dupage Hospital is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $52. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 9.15x the Medicare baseline. Located in 25 North Winfield Road, Winfield, IL.

Cash / Self-Pay

$52

Average discount available for prompt cash payment at this facility.

Insurance Median

$44

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: $52 (1081%)

Insurance Median: $44 (915%)

Cash: $52 (1081% of Medicare)

Ins. Median: $44 (915% 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 915% of the Medicare baseline (a markup of 815%). 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
Blue Cross Blue Shield	$5 - $154	104%
Countycare Il Cook Co [1607]	$5 - $11	104%
Medicaid / KanCare	$5 - $11	104%
Aetna	$10 - $54	208%
Carelon Behavioral Health [159]	$35 - $77	728%
Health'S Finest Network [126]	$35 - $140	728%
Multiplan/Phcs [142]	$40 - $154	832%
Dreyer Med Ipa Advocate [1409]	$42 - $92	873%
Humana	$42 - $154	873%
Magellan Behavioral Hlth [136]	$42 - $92	873%
Healthlink [125]	$44 - $97	915%
Choicecare [177]	$54 - $118	1123%
First Health Plan [6034]	$54 - $118	1123%
Cigna	$56 - $123	1164%
Compsych [112]	$56 - $123	1164%
UnitedHealthcare	$70 - $154	1455%

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 $52.
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 Northwestern Medicine Central Dupage Hospital 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.