CMS Price Transparency Data
Blood test, sodium
Facility: Mercy Health Saint Mary's
Billing Code: 84295 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 84295
- Insurance Median: $25
- Cash Discount Price: $22
- vs. Medicare Baseline: 5.20x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Mercy Health Saint Mary's is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $22. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 5.20x the Medicare baseline. Located in 200 Jefferson Avenue Se, Grand Rapids, MI.
Cash / Self-Pay
$22
Average discount available for prompt cash payment at this facility.
Insurance Median
$25
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: $22 (457%)
Insurance Median: $25 (520%)
Cash: $22 (457% of Medicare)
Ins. Median: $25 (520% 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 520% of the Medicare baseline (a markup of 420%). 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 - $26 | 42% |
| Access Health | $3 | 62% |
| Blue Cross Blue Shield | $3 - $5 | 62% |
| Medicaid / KanCare | $3 | 62% |
| Aetna | $5 - $15 | 104% |
| Align Senior Care | $5 | 104% |
| Blue Care Network Advantage | $5 | 104% |
| Correctional Recovery | $5 | 104% |
| Hospice Faith | $5 | 104% |
| Hospice Of Holland | $5 | 104% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $5 | 104% |
| Medicare (plans) | $5 | 104% |
| Oscar | $5 | 104% |
| UnitedHealthcare | $5 - $34 | 104% |
| Molina Marketplace | $6 | 125% |
| Geha | $7 - $26 | 146% |
| Medical Mutual | $7 | 146% |
| Meritain | $7 | 146% |
| Preferred One | $7 | 146% |
| Vitalcore | $7 | 146% |
| Wellpath | $7 | 146% |
| Nomi Health | $19 | 395% |
| Wc Accident Fund | $19 | 395% |
| Wc Advantage | $19 | 395% |
| Wc Aig | $19 | 395% |
| Wc Allied | $19 | 395% |
| Wc Amerisure | $19 | 395% |
| Wc Amtrust | $19 | 395% |
| Wc Asu Risk Mgt | $19 | 395% |
| Wc Berkley Admin | $19 | 395% |
| Wc Broadspire | $19 | 395% |
| Wc Bunch & Associates | $19 | 395% |
| Wc Ccmsi | $19 | 395% |
| Wc Emc Insurance Company | $19 | 395% |
| Wc Esis | $19 | 395% |
| Wc Fcci | $19 | 395% |
| Wc Federated | $19 | 395% |
| Wc Gallagher Bassett | $19 | 395% |
| Wc Genex Care For Ohio | $19 | 395% |
| Wc Guard Insurance Company | $19 | 395% |
| Wc Hartford | $19 | 395% |
| Wc Liberty Mutual | $19 | 395% |
| Wc Meijers | $19 | 395% |
| Wc Michigan | $19 | 395% |
| Wc Mitchell Frankenmuth | $19 | 395% |
| Wc Pma | $19 | 395% |
| Wc Sedgwick | $19 | 395% |
| Wc Sentry | $19 | 395% |
| Wc Travelers | $19 | 395% |
| Wc Tristar | $19 | 395% |
| Wc Walmart | $19 | 395% |
| Wc Zurich | $19 | 395% |
| Acs Benefit Services | $20 | 416% |
| Allied Benefit Systems | $20 | 416% |
| Claimchoice Adminstrators | $20 | 416% |
| Consociate | $20 | 416% |
| Cypress Benefit Administrators | $20 | 416% |
| Forest County Potawatomi | $20 | 416% |
| Health Smart | $20 | 416% |
| Healthgram | $20 | 416% |
| Healthscope | $20 | 416% |
| Secureone Preferred United Plans | $20 | 416% |
| Sisco Benefits | $20 | 416% |
| The Health Plan | $20 | 416% |
| Trustmark Small Business Benefits | $20 | 416% |
| Unified Group Services | $20 | 416% |
| Webtpa | $20 | 416% |
| Asr Health Benefits | $22 | 457% |
| Caresource | $22 | 457% |
| Hap | $22 - $26 | 457% |
| Varipro | $22 | 457% |
| 1199 National Benefit Fund | $25 | 520% |
| Allied National Global Care | $25 | 520% |
| Asrm - Reliance Standard Life Insurance | $25 | 520% |
| Christian Care Ministry | $25 | 520% |
| Cigna | $25 | 520% |
| Dean Health | $25 | 520% |
| Fallon Health | $25 | 520% |
| Family Life Insurance Company | $25 | 520% |
| Ghc Scw | $25 | 520% |
| Group Pension Administrators | $25 | 520% |
| International Benefit Administrators | $25 | 520% |
| Lifetime Benefit Solutions | $25 | 520% |
| Manhattan Life | $25 | 520% |
| Medi Share | $25 | 520% |
| Multiplan | $25 | 520% |
| Mvp | $25 | 520% |
| Pai | $25 | 520% |
| Pan-American Life | $25 | 520% |
| Paramount Hmo | $25 | 520% |
| Phcs | $25 | 520% |
| Trinity Health Share | $25 | 520% |
| Acclaim | $26 | 541% |
| Administrative Concepts | $26 | 541% |
| Allegeant | $26 | 541% |
| Ameriben | $26 | 541% |
| American Family | $26 | 541% |
| American Healthcare Alliance | $26 | 541% |
| American Republic | $26 | 541% |
| Amerihealth | $26 | 541% |
| Aultcare | $26 | 541% |
| Automated Benefit Services | $26 | 541% |
| Auxiant | $26 | 541% |
| Benefit Administrative Systems,Llc | $26 | 541% |
| Boon Chapman | $26 | 541% |
| Cam Administrative Services | $26 | 541% |
| Christian Brother Services | $26 | 541% |
| Christian Brothers Holy Cross | $26 | 541% |
| Comprehensive Benefits | $26 | 541% |
| Continental Life Insurance | $26 | 541% |
| Custom Benefit Administrators | $26 | 541% |
| Employee Benefit Concepts | $26 | 541% |
| Employee Benefit Management | $26 | 541% |
| Enterprise Group Planning | $26 | 541% |
| Freedom Life Insurance Company | $26 | 541% |
| Group Administrators | $26 | 541% |
| Group Marketing Services | $26 | 541% |
| Guardian | $26 | 541% |
| Health America | $26 | 541% |
| Health Choices | $26 | 541% |
| Healthez | $26 | 541% |
| Humana | $26 - $34 | 541% |
| Insight | $26 | 541% |
| Intercare | $26 | 541% |
| Jfp Benefit Management | $26 | 541% |
| Jp Farley Corporation | $26 | 541% |
| Key Benefit Administrator | $26 | 541% |
| Liberty Union Life Assurance Co | $26 | 541% |
| Lucent Health | $26 | 541% |
| Luminare Health | $26 | 541% |
| Luminare Health (Detroit) | $26 | 541% |
| Medben | $26 | 541% |
| Medcost | $26 | 541% |
| Mutual Health Services | $26 | 541% |
| Mutual Of Omaha | $26 | 541% |
| Ncas | $26 | 541% |
| Nippon Life Ins | $26 | 541% |
| Nova | $26 | 541% |
| Painters Union Insurance Fund | $26 | 541% |
| Physicians Mutual | $26 | 541% |
| Plumbers Local 98 Insurance Fund | $26 | 541% |
| Prairie States | $26 | 541% |
| Primary Physician Care | $26 | 541% |
| Professional Benefit Administrators | $26 | 541% |
| The Loomis Company | $26 | 541% |
| Unicare | $26 | 541% |
| Us Health And Life | $26 | 541% |
| Valenz | $26 | 541% |
| Western & Southern Financial Group | $26 | 541% |
| Wps | $26 | 541% |
| Coventry | $27 | 561% |
| First Health | $27 | 561% |
| Priority Health | $28 - $29 | 582% |
| Cmh Allegan County | $34 | 707% |
| Cmh Ausable Valley | $34 | 707% |
| Cmh Barry County | $34 | 707% |
| Cmh Berrien County | $34 | 707% |
| Cmh Cass County | $34 | 707% |
| Cmh Clinton-Eaton-Ingham County | $34 | 707% |
| Cmh Kalamazoo | $34 | 707% |
| Cmh Kent County | $34 | 707% |
| Cmh Lenawee County | $34 | 707% |
| Cmh Misc | $34 | 707% |
| Cmh Monroe County | $34 | 707% |
| Cmh Montcalm County | $34 | 707% |
| Cmh Muskegon County | $34 | 707% |
| Cmh Newaygo County | $34 | 707% |
| Cmh North Country | $34 | 707% |
| Cmh Northern Lakes County | $34 | 707% |
| Cmh Ottawa County | $34 | 707% |
| Cmh Van Buren County | $34 | 707% |
| Cmh West Mi County | $34 | 707% |
| Magellan Behavioral Health | $34 | 707% |