CMS Price Transparency Data

Blood test, sodium

Facility: Essentia Health Virginia

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $36
  • Cash Discount Price: $48
  • vs. Medicare Baseline: 7.48x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Essentia Health Virginia is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $48. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 7.48x the Medicare baseline. Located in 901 9Th Street North, Virginia, MN.
Cash / Self-Pay
$48

Average discount available for prompt cash payment at this facility.

Insurance Median
$36

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: $48 (998%)
Insurance Median: $36 (748%)
Cash: $48 (998% of Medicare)
Ins. Median: $36 (748% 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 748% of the Medicare baseline (a markup of 648%). 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
Advocare/Security Health $5 104%
Blue Cross Blue Shield $5 - $65 104%
Freedom Blue Ppo $5 104%
Healthpartners Care Msho / Mcr Adv $5 104%
Imcare Msho Pcc Prime $5 104%
Imcare Msho Ref Req $5 104%
Itasca Med Care $5 104%
Medica Advantage Solutions $5 104%
Medica Msho/Dual Solutions $5 104%
Medica Prime Solution Group $5 104%
Medicare (plans) $5 104%
Nd Va Administration $5 104%
Platinum Blue/Vantage Blue $5 104%
Primewest $5 104%
Primewest Msho $5 104%
Secure Blue Msho $5 104%
Ubh Cost Plan $5 104%
Ubh Msho $5 104%
Ucare Msho $5 104%
UnitedHealthcare $5 - $67 104%
Sanford Healthplan $15 - $34 312%
Medica Access $17 353%
Healthpartners Care Pmap $30 624%
Blue Plus Pmap Pcc Prime $36 - $51 748%
Medica $48 - $54 998%
Medica Uplan $48 998%
Ucare $50 1040%
Healthpartners $54 - $69 1123%
Medica Choice $55 1143%
Wea $55 - $59 1143%
America'S Ppo $59 1227%
Security Health $59 1227%
Wps $63 - $64 1310%
Aetna $65 1351%
Cigna $68 - $69 1414%
Healthpartners Pcc Prime $68 - $69 1414%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 9Th Street North, Virginia, MN 55792
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals