CMS Price Transparency Data

Blood test, sodium

Facility: Fayette County Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $51
  • Cash Discount Price: $79
  • vs. Medicare Baseline: 10.60x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Fayette County Hospital is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $79. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 10.60x the Medicare baseline. Located in 650 W Taylor St, Vandalia, IL.
Cash / Self-Pay
$79

Average discount available for prompt cash payment at this facility.

Insurance Median
$51

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: $79 (1642%)
Insurance Median: $51 (1060%)
Cash: $79 (1642% of Medicare)
Ins. Median: $51 (1060% 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 1060% of the Medicare baseline (a markup of 960%). 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
Aetna $9 - $55 187%
Blue Cross Blue Shield $9 - $66 187%
Illinicare - All Plans $9 187%
Medicaid / KanCare $9 187%
Meridian-All Plans $9 187%
Health Alliance Mcare $25 520%
Healthlink Mcr Adv $25 520%
Humana $25 520%
Coventry/Ghp-All Plans $51 1060%
Healthlink Hmo $55 1143%
Cigna $59 1227%
Healthlink Ppo - All Other Plans $63 1310%
Health Alliance - All Other Plans $65 1351%
UnitedHealthcare $66 1372%
Multiplan - All Plans $67 1393%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 650 W Taylor St, Vandalia, IL 62471
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals