CMS Price Transparency Data
Blood test, sodium
Facility: Mercy Health Lakeshore Campus
Billing Code: 84295 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 84295
- Insurance Median: $29
- Cash Discount Price: $22
- vs. Medicare Baseline: 6.03x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Mercy Health Lakeshore Campus is $29. 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 6.03x the Medicare baseline. Located in 72 South State Street, Shelby, MI.
Cash / Self-Pay
$22
Average discount available for prompt cash payment at this facility.
Insurance Median
$29
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: $29 (603%)
Cash: $22 (457% of Medicare)
Ins. Median: $29 (603% 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 603% of the Medicare baseline (a markup of 503%). 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.
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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 - $30 | 42% |
| Blue Cross Blue Shield | $4 - $29 | 83% |
| Medicaid / KanCare | $4 | 83% |
| Access Health | $5 | 104% |
| Aetna | $5 - $27 | 104% |
| Align Senior Care | $5 | 104% |
| Blue Care Network Advantage | $5 | 104% |
| Correctional Recovery | $5 | 104% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $5 | 104% |
| Medicare (plans) | $5 - $8 | 104% |
| Vitalcore | $7 | 146% |
| Wellpath | $7 | 146% |
| Oscar | $10 | 208% |
| UnitedHealthcare | $12 - $31 | 249% |
| Molina Marketplace | $14 | 291% |
| Hospice Of Michigan | $19 | 395% |
| Nomi Health | $19 | 395% |
| Hap | $25 | 520% |
| Geha | $27 - $31 | 561% |
| Meritain | $27 | 561% |
| Wc Accident Fund | $27 | 561% |
| Wc Advantage | $27 | 561% |
| Wc Aig | $27 | 561% |
| Wc Allied | $27 | 561% |
| Wc Amerisure | $27 | 561% |
| Wc Amtrust | $27 | 561% |
| Wc Asu Risk Mgt | $27 | 561% |
| Wc Berkley Admin | $27 | 561% |
| Wc Broadspire | $27 | 561% |
| Wc Bunch & Associates | $27 | 561% |
| Wc Ccmsi | $27 | 561% |
| Wc Emc Insurance Company | $27 | 561% |
| Wc Esis | $27 | 561% |
| Wc Fcci | $27 | 561% |
| Wc Federated | $27 | 561% |
| Wc Gallagher Bassett | $27 | 561% |
| Wc Genex Care For Ohio | $27 | 561% |
| Wc Guard Insurance Company | $27 | 561% |
| Wc Hartford | $27 | 561% |
| Wc Liberty Mutual | $27 | 561% |
| Wc Meijers | $27 | 561% |
| Wc Michigan | $27 | 561% |
| Wc Mitchell Frankenmuth | $27 | 561% |
| Wc Pma | $27 | 561% |
| Wc Sedgwick | $27 | 561% |
| Wc Sentry | $27 | 561% |
| Wc Travelers | $27 | 561% |
| Wc Tristar | $27 | 561% |
| Wc Walmart | $27 | 561% |
| Wc Zurich | $27 | 561% |
| Asr Health Benefits | $28 | 582% |
| 1199 National Benefit Fund | $29 | 603% |
| Allied National Global Care | $29 | 603% |
| Asrm - Reliance Standard Life Insurance | $29 | 603% |
| Bcn Domestic | $29 | 603% |
| Blue Benefit Administrators Of Massachusetts | $29 | 603% |
| Blue Care Network | $29 | 603% |
| Blue Distinction Transplant | $29 | 603% |
| Blue Shield - Ca | $29 | 603% |
| Blue Shield - Id (Regence) | $29 | 603% |
| Blue Shield - Ny Highmark Northeastern | $29 | 603% |
| Blue Shield - Ny Highmark Western | $29 | 603% |
| Blue Shield - Pa (Highmark) | $29 | 603% |
| Blue Shield - Wa (Regence) | $29 | 603% |
| Christian Care Ministry | $29 | 603% |
| Dean Health | $29 | 603% |
| Fallon Health | $29 | 603% |
| Family Life Insurance Company | $29 | 603% |
| Ghc Scw | $29 | 603% |
| Group Pension Administrators | $29 | 603% |
| Health Choices | $29 - $30 | 603% |
| International Benefit Administrators | $29 | 603% |
| Kaiser Domestic | $29 | 603% |
| Lifetime Benefit Solutions | $29 | 603% |
| Manhattan Life | $29 | 603% |
| Medi Share | $29 | 603% |
| Multiplan | $29 | 603% |
| Mvp | $29 | 603% |
| Pai | $29 | 603% |
| Pan-American Life | $29 | 603% |
| Paramount Hmo | $29 | 603% |
| Phcs | $29 | 603% |
| Trinity Health Share | $29 | 603% |
| Acclaim | $30 | 624% |
| Administrative Concepts | $30 | 624% |
| Allegeant | $30 | 624% |
| Allied Benefit Systems | $30 | 624% |
| Ameriben | $30 | 624% |
| American Family | $30 | 624% |
| American Healthcare Alliance | $30 | 624% |
| American Republic | $30 | 624% |
| Amerihealth | $30 | 624% |
| Aultcare | $30 | 624% |
| Automated Benefit Services | $30 | 624% |
| Auxiant | $30 | 624% |
| Benefit Administrative Systems,Llc | $30 | 624% |
| Boon Chapman | $30 | 624% |
| Cam Administrative Services | $30 | 624% |
| Christian Brother Services | $30 | 624% |
| Christian Brothers Holy Cross | $30 | 624% |
| Cigna | $30 | 624% |
| Claimchoice Adminstrators | $30 | 624% |
| Comprehensive Benefits | $30 | 624% |
| Consociate | $30 | 624% |
| Continental Life Insurance | $30 | 624% |
| Custom Benefit Administrators | $30 | 624% |
| Cypress Benefit Administrators | $30 | 624% |
| Employee Benefit Concepts | $30 | 624% |
| Employee Benefit Management | $30 | 624% |
| Enterprise Group Planning | $30 | 624% |
| Forest County Potawatomi | $30 | 624% |
| Freedom Life Insurance Company | $30 | 624% |
| Group Administrators | $30 | 624% |
| Group Marketing Services | $30 | 624% |
| Guardian | $30 | 624% |
| Health America | $30 | 624% |
| Health Smart | $30 | 624% |
| Healthez | $30 | 624% |
| Healthgram | $30 | 624% |
| Healthscope | $30 | 624% |
| Humana | $30 | 624% |
| Insight | $30 | 624% |
| Intercare | $30 | 624% |
| Jfp Benefit Management | $30 | 624% |
| Jp Farley Corporation | $30 | 624% |
| Key Benefit Administrator | $30 | 624% |
| Liberty Union Life Assurance Co | $30 | 624% |
| Lucent Health | $30 | 624% |
| Luminare Health | $30 | 624% |
| Luminare Health (Detroit) | $30 | 624% |
| Medben | $30 | 624% |
| Medcost | $30 | 624% |
| Medical Mutual | $30 | 624% |
| Mutual Health Services | $30 | 624% |
| Mutual Of Omaha | $30 | 624% |
| Ncas | $30 | 624% |
| Nippon Life Ins | $30 | 624% |
| Nova | $30 | 624% |
| Painters Union Insurance Fund | $30 | 624% |
| Physicians Mutual | $30 | 624% |
| Plumbers Local 98 Insurance Fund | $30 | 624% |
| Prairie States | $30 | 624% |
| Primary Physician Care | $30 | 624% |
| Professional Benefit Administrators | $30 | 624% |
| Secureone Preferred United Plans | $30 | 624% |
| The Loomis Company | $30 | 624% |
| Trustmark Small Business Benefits | $30 | 624% |
| Unicare | $30 | 624% |
| Unified Group Services | $30 | 624% |
| Us Health And Life | $30 | 624% |
| Valenz | $30 | 624% |
| Varipro | $30 | 624% |
| Western & Southern Financial Group | $30 | 624% |
| Wps | $30 | 624% |
| First Health | $31 | 644% |
| Priority Health | $31 | 644% |