CMS Price Transparency Data

Blood test, sodium

Facility: Woodlawn Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $15
  • Cash Discount Price: $53
  • vs. Medicare Baseline: 3.12x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Woodlawn Hospital is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $53. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 3.12x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.
Cash / Self-Pay
$53

Average discount available for prompt cash payment at this facility.

Insurance Median
$15

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: $53 (1102%)
Insurance Median: $15 (312%)
Cash: $53 (1102% of Medicare)
Ins. Median: $15 (312% 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 312% of the Medicare baseline (a markup of 212%). 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
Blue Cross Blue Shield $2 - $53 42%
Partners Direct Health-All Plans $3 62%
UnitedHealthcare $3 - $53 62%
Caresource Mcaid Hww $5 104%
Mdwise Excel Hhw & Hcc $5 104%
Mhs Mcaid Hcc $5 104%
Mhs Mcaid Hhw $5 104%
Aetna $15 - $66 312%
Caresource Mcaid Hip $15 312%
Caresource Mcr Adv $15 312%
Humana $15 - $54 312%
Mdwise Mcaid Excel Hip $15 312%
Mhs Exch Mrktplce-All Other Plans $15 312%
Mhs Mcaid Hip $15 312%
Mhs Mcr Adv $16 333%
Ambetter / Centene $20 416%
Caresource Exch - All Other Plans $20 416%
Cigna $50 - $60 1040%
Parkview Health Plans-All Plans $52 1081%
Sagamore All Other Grps - All Other Plans $59 1227%
Encore Comm-All Plans $60 1247%
Phcs/Multiplan-All Plans $65 1351%
Community Health Alliance-All Plans $66 1372%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1400 E 9Th St, Rochester, IN 46975
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals