CMS Price Transparency Data

Blood test, sodium

Facility: Norton-King's Daughters' Health

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84295
Insurance Median: $30
Cash Discount Price: $8
vs. Medicare Baseline: 6.24x Medicare

The contracted insurance negotiated median rate for a Blood test, sodium at Norton-King's Daughters' Health is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 6.24x the Medicare baseline. Located in 1373 East Sr 62, Madison, IN.

Cash / Self-Pay

Average discount available for prompt cash payment at this facility.

Insurance Median

$30

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: $8 (166%)

Insurance Median: $30 (624%)

Cash: $8 (166% of Medicare)

Ins. Median: $30 (624% 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 624% of the Medicare baseline (a markup of 524%). 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
Aetna	$4 - $33	83%
Blue Cross Blue Shield	$5 - $15	104%
Humana	$5	104%
Managed Health Services	$5 - $7	104%
Managed Health Services Of Indiana	$5	104%
Managed Health Services Of Kentucky	$5	104%
Passport By Molina	$5	104%
UnitedHealthcare	$5 - $30	104%
Caresource Of Indiana	$7	146%
Caresource Of Kentucky	$7	146%
Custom Design Benefits	$10 - $19	208%
Cigna	$32	665%
Encore	$32	665%
Bluegrass	$34	707%
First Health	$34	707%
Healthlink	$34	707%
Quality Care Partners	$34	707%
Vha/Tristate	$34	707%
Multiplan/Phcs	$35	728%
Indiana Health Network	$36	748%
Siho	$36	748%

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 $8.
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 Norton-King's Daughters' Health 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.