CMS Price Transparency Data

Blood test, sodium

Facility: Methodist Hospitals Inc

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $21
  • Cash Discount Price: $32
  • vs. Medicare Baseline: 4.37x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Methodist Hospitals Inc is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 4.37x the Medicare baseline. Located in 600 Grant St, Gary, IN.
Cash / Self-Pay
$32

Average discount available for prompt cash payment at this facility.

Insurance Median
$21

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: $32 (665%)
Insurance Median: $21 (437%)
Cash: $32 (665% of Medicare)
Ins. Median: $21 (437% 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 437% of the Medicare baseline (a markup of 337%). 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 $5 - $41 104%
Blue Cross Blue Shield $5 - $48 104%
Caresource $5 104%
Humana $5 104%
Managed Health Services $5 104%
Medicaid / KanCare $5 104%
Medicare (plans) $5 104%
United Heathcare $5 104%
UnitedHealthcare $5 - $7 104%
Zing $5 104%
Caresource Maketplace $8 166%
Ambetter / Centene $10 208%
Cigna $13 - $23 270%
Magnacare $13 270%
Physicians Health Plan Of Northern Indiana $14 291%
Encore $21 - $50 437%
Phcs $24 - $38 499%
Siho $24 - $39 499%
Sagamore $25 - $40 520%
Multiplan $26 - $41 541%
Hfn $27 - $48 561%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 Grant St, Gary, IN 46402
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals