CMS Price Transparency Data

Blood test, sodium

Facility: Jacksonville Memorial Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84295
Insurance Median: $32
Cash Discount Price: $58
vs. Medicare Baseline: 6.65x Medicare

The contracted insurance negotiated median rate for a Blood test, sodium at Jacksonville Memorial Hospital is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $58. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 6.65x the Medicare baseline. Located in 1600 W Walnut St, Jacksonville, IL.

Cash / Self-Pay

$58

Average discount available for prompt cash payment at this facility.

Insurance Median

$32

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: $58 (1206%)

Insurance Median: $32 (665%)

Cash: $58 (1206% of Medicare)

Ins. Median: $32 (665% 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 665% of the Medicare baseline (a markup of 565%). 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	$4 - $70	83%
Coventry	$5 - $11	104%
Health Alliance	$5 - $48	104%
Humana	$5 - $60	104%
Medicare (plans)	$5 - $11	104%
Tricare	$5 - $13	104%
UnitedHealthcare	$5 - $50	104%
Medicaid / KanCare	$9	187%
Molina Healthcare	$9	187%
Corvel/Corcare	$18 - $21	374%
Illinois Workers Compensation	$19 - $43	395%
Health Alliance Mh Employee Plan	$21 - $32	437%
Current Health Network	$25 - $52	520%
6 Degrees Health	$28 - $42	582%
Hope Trust	$28 - $42	582%
Hst	$28 - $42	582%
Aetna	$32 - $56	665%
Cigna	$32 - $49	665%
Healthlink	$39 - $60	811%
Commercial Workers Compensation	$40	832%
Phcs/Multiplan	$41 - $63	852%
Hfn	$44 - $66	915%
Liability	$46 - $70	956%

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 $58.
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 Jacksonville Memorial 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.