CMS Price Transparency Data

Blood test, sodium

Facility: Saint Joseph Regional Medical Center

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $11
  • Cash Discount Price: $23
  • vs. Medicare Baseline: 2.29x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Saint Joseph Regional Medical Center is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 2.29x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$23

Average discount available for prompt cash payment at this facility.

Insurance Median
$11

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: $23 (478%)
Insurance Median: $11 (229%)
Cash: $23 (478% of Medicare)
Ins. Median: $11 (229% 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 229% of the Medicare baseline (a markup of 129%). 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 $3 - $18 62%
Blue Cross Blue Shield $3 - $10 62%
Medicaid / KanCare $3 - $5 62%
UnitedHealthcare $3 - $23 62%
County Coroner $5 104%
Managed Health Services - Indiana $5 104%
Mdwise $5 104%
Medicare (plans) $5 104%
Meridian Complete $5 104%
Pace-Trinity Health $5 104%
Provider Partners Health Plan Of Indiana $5 104%
Auxiant $7 - $30 146%
Caresource $7 146%
Physicians Health Plan Northern Indiana Health Insurance $7 - $15 146%
St Joseph County Hlth Dpt $7 146%
Siho Insurance Services $8 166%
Allied Benefit Systems $9 - $23 187%
Hospice Of Marshall County $9 187%
Hospice Of St Joseph County $9 187%
Key Benefit Administrator $9 - $22 187%
Blue Benefit Administrators Of Massachusetts $10 208%
Blue Care Network $10 208%
Blue Distinction Transplant $10 208%
Blue Shield - Ca $10 208%
Blue Shield - Id (Regence) $10 208%
Blue Shield - Ny Highmark Northeastern $10 208%
Blue Shield - Ny Highmark Western $10 208%
Blue Shield - Pa (Highmark) $10 208%
Blue Shield - Wa (Regence) $10 208%
Custom Design Benefits $10 208%
Plain Church Group $10 208%
Asr Health Benefits $18 374%
Christian Brother Services $18 374%
Employee Benefit Management $18 374%
Medical Mutual $18 374%
Meritain $18 374%
Preferred One $18 374%
Rural Carrier Health Benefit Plan $18 374%
Webtpa $18 374%
Notre Dame Athletic Association $20 416%
Wc Notre Dame $20 416%
Encore Health $21 - $22 437%
Luminare Health (Detroit) $21 - $22 437%
Ameriben $22 457%
Indiana Criminal Justice Inst $22 457%
Western & Southern Financial Group $22 457%
Cigna $23 478%
Geha $23 478%
Group Administrators $23 478%
Health Partners $23 478%
Healthscope $23 478%
Mvp $23 478%
Prairie States $23 478%
Priority Health $23 478%
Professional Benefit Administrators $23 478%
Sagamore Health Network $23 - $27 478%
Sisco Benefits $23 478%
Student Insurance Cma $23 478%
Unified Group Services $23 478%
Goshen Preferred Network $28 - $31 582%
Christian Brothers Holy Cross $29 603%
Signature Care $29 603%
Bankers Life Casualty $36 748%
Bureau Of Disability $36 748%
Wc Align Network $36 748%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5215 Holy Cross Pkwy, Mishawaka, IN 46545
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals