CMS Price Transparency Data
Blood test, sodium
Facility: Trinity Health Oakland Hospital
Billing Code: 84295 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 84295
- Insurance Median: $15
- Cash Discount Price: $358
- vs. Medicare Baseline: 3.12x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Trinity Health Oakland Hospital is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $358. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 3.12x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.
Cash / Self-Pay
$358
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: $358 (7443%)
Insurance Median: $15 (312%)
Cash: $358 (7443% 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 |
|---|---|---|
| U Of M Health Plan | $2 | 42% |
| Blue Cross Blue Shield | $3 - $5 | 62% |
| Medicaid / KanCare | $3 | 62% |
| Aetna | $5 - $14 | 104% |
| Align Senior Care | $5 | 104% |
| Blue Care Network Advantage | $5 | 104% |
| Cca - Zing Health | $5 | 104% |
| Hospice Advantage | $5 | 104% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $5 | 104% |
| Medicare (plans) | $5 | 104% |
| UnitedHealthcare | $5 - $24 | 104% |
| Molina Marketplace | $6 | 125% |
| Geha | $7 - $24 | 146% |
| Health Cost Solutions | $7 | 146% |
| Medical Mutual | $7 | 146% |
| Meritain | $7 | 146% |
| Priority Health | $7 - $8 | 146% |
| Vitalcore | $7 | 146% |
| Wellpath | $7 | 146% |
| Wc Accident Fund | $10 | 208% |
| Wc Advantage | $10 | 208% |
| Wc Aig | $10 | 208% |
| Wc Allied | $10 | 208% |
| Wc Amerisure | $10 | 208% |
| Wc Amtrust | $10 | 208% |
| Wc Asu Risk Mgt | $10 | 208% |
| Wc Berkley Admin | $10 | 208% |
| Wc Broadspire | $10 | 208% |
| Wc Bunch & Associates | $10 | 208% |
| Wc Ccmsi | $10 | 208% |
| Wc Emc Insurance Company | $10 | 208% |
| Wc Esis | $10 | 208% |
| Wc Fcci | $10 | 208% |
| Wc Federated | $10 | 208% |
| Wc Gallagher Bassett | $10 | 208% |
| Wc Genex Care For Ohio | $10 | 208% |
| Wc Guard Insurance Company | $10 | 208% |
| Wc Hartford | $10 | 208% |
| Wc Liberty Mutual | $10 | 208% |
| Wc Meijers | $10 | 208% |
| Wc Michigan | $10 | 208% |
| Wc Mitchell Frankenmuth | $10 | 208% |
| Wc Pma | $10 | 208% |
| Wc Sedgwick | $10 | 208% |
| Wc Sentry | $10 | 208% |
| Wc Travelers | $10 | 208% |
| Wc Tristar | $10 | 208% |
| Wc Walmart | $10 | 208% |
| Wc Zurich | $10 | 208% |
| Employee Benefit Logistic | $11 | 229% |
| Acs Benefit Services | $14 | 291% |
| Allied Benefit Systems | $14 | 291% |
| Claimchoice Adminstrators | $14 | 291% |
| Consociate | $14 | 291% |
| Cypress Benefit Administrators | $14 | 291% |
| Forest County Potawatomi | $14 | 291% |
| Health Smart | $14 | 291% |
| Healthgram | $14 | 291% |
| Healthscope | $14 | 291% |
| Secureone Preferred United Plans | $14 | 291% |
| Sisco Benefits | $14 | 291% |
| The Health Plan | $14 | 291% |
| Trustmark Small Business Benefits | $14 | 291% |
| Unified Group Services | $14 | 291% |
| Webtpa | $14 | 291% |
| Asr Health Benefits | $15 | 312% |
| Caresource | $15 | 312% |
| Hap | $15 - $23 | 312% |
| Mclaren Health | $15 - $17 | 312% |
| Varipro | $15 | 312% |
| Carelon Behavioral Health | $16 | 333% |
| Magellan Behavioral Health | $19 | 395% |
| 1199 National Benefit Fund | $22 | 457% |
| Allied National Global Care | $22 | 457% |
| Asrm - Reliance Standard Life Insurance | $22 | 457% |
| Christian Care Ministry | $22 | 457% |
| Dean Health | $22 | 457% |
| Fallon Health | $22 | 457% |
| Family Life Insurance Company | $22 | 457% |
| Ghc Scw | $22 | 457% |
| Group Pension Administrators | $22 | 457% |
| International Benefit Administrators | $22 | 457% |
| Lifetime Benefit Solutions | $22 | 457% |
| Manhattan Life | $22 | 457% |
| Medi Share | $22 | 457% |
| Multiplan | $22 | 457% |
| Mvp | $22 | 457% |
| Pai | $22 | 457% |
| Pan-American Life | $22 | 457% |
| Paramount Hmo | $22 | 457% |
| Phcs | $22 | 457% |
| Trinity Health Share | $22 | 457% |
| Access Health | $23 | 478% |
| Acclaim | $23 | 478% |
| Administrative Concepts | $23 | 478% |
| Allegeant | $23 | 478% |
| Ameriben | $23 | 478% |
| American Family | $23 | 478% |
| American Healthcare Alliance | $23 | 478% |
| American National | $23 | 478% |
| American Republic | $23 | 478% |
| Amerihealth | $23 | 478% |
| Aultcare | $23 | 478% |
| Automated Benefit Services | $23 | 478% |
| Auxiant | $23 | 478% |
| Benefit Administrative Systems,Llc | $23 | 478% |
| Boon Chapman | $23 | 478% |
| Cam Administrative Services | $23 | 478% |
| Christian Brother Services | $23 | 478% |
| Christian Brothers Holy Cross | $23 | 478% |
| Comprehensive Benefits | $23 | 478% |
| Continental Life Insurance | $23 | 478% |
| Custom Benefit Administrators | $23 | 478% |
| Employee Benefit Concepts | $23 | 478% |
| Employee Benefit Management | $23 | 478% |
| Enterprise Group Planning | $23 | 478% |
| Freedom Life Insurance Company | $23 | 478% |
| Group Administrators | $23 | 478% |
| Group Marketing Services | $23 | 478% |
| Guardian | $23 | 478% |
| Health America | $23 | 478% |
| Health Choices | $23 | 478% |
| Health Partners | $23 | 478% |
| Healthcare Management Admin | $23 | 478% |
| Healthez | $23 | 478% |
| Humana | $23 | 478% |
| Insight | $23 | 478% |
| Intercare | $23 | 478% |
| Jfp Benefit Management | $23 | 478% |
| Jp Farley Corporation | $23 | 478% |
| Key Benefit Administrator | $23 | 478% |
| Liberty Union Life Assurance Co | $23 | 478% |
| Lucent Health | $23 | 478% |
| Luminare Health | $23 | 478% |
| Luminare Health (Detroit) | $23 | 478% |
| Magnacare | $23 | 478% |
| Medben | $23 | 478% |
| Medcost | $23 | 478% |
| Mutual Health Services | $23 | 478% |
| Mutual Of Omaha | $23 | 478% |
| Ncas | $23 | 478% |
| Nippon Life Ins | $23 | 478% |
| Nova | $23 | 478% |
| Painters Union Insurance Fund | $23 | 478% |
| Physicians Mutual | $23 | 478% |
| Plumbers Local 98 Insurance Fund | $23 | 478% |
| Prairie States | $23 | 478% |
| Preferred One | $23 | 478% |
| Primary Physician Care | $23 | 478% |
| Professional Benefit Administrators | $23 | 478% |
| Siho Insurance Services | $23 | 478% |
| The Loomis Company | $23 | 478% |
| Tufts Health Plan | $23 | 478% |
| Unicare | $23 | 478% |
| Us Health And Life | $23 | 478% |
| Valenz | $23 | 478% |
| Western & Southern Financial Group | $23 | 478% |
| Wps | $23 | 478% |
| Cigna | $24 | 499% |
| Coventry | $24 | 499% |
| First Health | $24 | 499% |
| Prime Health Services | $26 | 541% |
| Three Rivers Provider Network | $29 | 603% |
| Cmh Detroit Wayne Integrated Health Network | $32 | 665% |
| Cmh Lenawee County | $32 | 665% |
| Cmh Livingston County | $32 | 665% |
| Cmh Misc | $32 | 665% |
| Cmh Monroe County | $32 | 665% |
| Cmh Oakland County | $32 | 665% |
| Cmh Washtenaw County | $32 | 665% |