CMS Price Transparency Data

Blood test, sodium

Facility: Hermann Area District Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $26
  • Cash Discount Price: $27
  • vs. Medicare Baseline: 5.41x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Hermann Area District Hospital is $26. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 5.41x the Medicare baseline. Located in 509 W 18Th St, Hermann, MO.
Cash / Self-Pay
$27

Average discount available for prompt cash payment at this facility.

Insurance Median
$26

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: $27 (561%)
Insurance Median: $26 (541%)
Cash: $27 (561% of Medicare)
Ins. Median: $26 (541% 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 541% of the Medicare baseline (a markup of 441%). 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
Coventry - All Plans $2 42%
UnitedHealthcare $7 - $19 146%
Cigna $18 374%
Tricare $18 374%
Choicecare Mcr Adv- All Plans $19 395%
Aetna $20 - $43 416%
American Hlth Mcr Adv- All Plans $20 416%
Blue Cross Blue Shield $20 - $37 416%
Humana $20 416%
Wellcare Mcr Adv - All Plans $20 416%
Harmony Hp Mcaid- All Plans $26 541%
Healthcare Usa Mcaid- All Plans $30 624%
Healthlink Hmo $30 624%
Ambetter / Centene $32 665%
Healthlink Ppo - All Other Plans $34 707%
Multiplan/Phcs - All Plans $34 707%
Comp Results - All Plans $41 852%
Three Rivers - All Plans $41 852%
Care Partners Mcaid- All Plans $46 956%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 509 W 18Th St, Hermann, MO 65041
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals