CMS Price Transparency Data

Blood test, sodium

Facility: Promedica Monroe Regional Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $6
  • Cash Discount Price: $12
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Promedica Monroe Regional Hospital is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 1.25x the Medicare baseline. Located in 718 N Macomb St, Monroe, MI.
Cash / Self-Pay
$12

Average discount available for prompt cash payment at this facility.

Insurance Median
$6

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: $12 (249%)
Insurance Median: $6 (125%)
Cash: $12 (249% of Medicare)
Ins. Median: $6 (125% 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.

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 - $5 62%
Blue Cross Blue Shield $3 - $11 62%
Meridian $3 62%
Molina Healthcare Of Michigan $3 62%
Priority Health $3 - $10 62%
UnitedHealthcare $3 - $15 62%
Health Alliance Plan $5 - $6 104%
Humana $5 104%
Paramount Healthcare Inc $5 - $14 104%
Veterans Affairs $5 104%
Amerihealth $8 166%
Frontpath $11 229%
Encore Health Network $13 270%
Health Ohio Network, Llc $13 270%
Cofinity $14 291%
Multiplan $17 353%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 718 N Macomb St, Monroe, MI 48162
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals