CMS Price Transparency Data

Blood test, sodium

Facility: Mercy Hospital Lincoln

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $36
  • Cash Discount Price: $49
  • vs. Medicare Baseline: 7.48x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Mercy Hospital Lincoln is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 7.48x the Medicare baseline. Located in 1000 East Cherry Street, Troy, MO.
Cash / Self-Pay
$49

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: $49 (1019%)
Insurance Median: $36 (748%)
Cash: $49 (1019% 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
Medicaid / KanCare $5 - $34 104%
United Medical Resources Contracted [320454] $5 104%
UnitedHealthcare $5 - $18 104%
Blue Cross Blue Shield $6 - $36 125%
Cigna $6 - $19 125%
Healthlink Contracted [320179] $7 - $64 146%
Aetna $11 - $49 229%
Medicare (plans) $16 - $75 333%
Tricare $16 333%
American Health Advantage Of Mo Mcr [10473] $18 374%
Cherokee Nation Health Serv Contracted [320066] $18 374%
Cross Timbers Hospice [20098] $18 374%
Dept Of Veteran Affairs Contracted [320106] $18 374%
Elara Caring Aspire Hospice Contracted [320433] $18 374%
Elara Caring Aspire Hospice [20433] $18 374%
Globalhealth Contracted [320145] $18 374%
Halo Hcr Inc Hospice Contracted [320432] $18 374%
Halo Hcr Inc Hospice [20432] $18 374%
Humana $18 - $68 374%
Indian Health Service Contracted [320198] $18 374%
Kindful Hospice Contracted [320434] $18 374%
Kindful Hospice [20434] $18 374%
Mercy Hospice Okc [20252] $18 374%
Pace Of The Ozarks Contracted [320518] $18 374%
Provider Partners Health Plans Contracted [320450] $18 374%
Qual Choice Contracted [320325] $18 374%
Centivo Contracted [320505] $27 561%
Medica Contracted [320239] $32 665%
Ambetter / Centene $34 707%
Home State Health Plan Contracted [320187] $34 707%
Novasys Contracted [320285] $34 707%
Hope Trust Contracted [320488] $37 769%
Health Choices Contracted [320448] $45 936%
Health Choices [20448] $45 936%
Medical Associates Health Contracted [320444] $45 936%
First Health Contracted [320128] $49 - $56 1019%
Mercy Mgd Behavioral Health Contracted [320259] $56 1164%
Multiplan Contracted [320270] $56 1164%
Private Health Care Systems Contracted [320320] $56 1164%
Workers Comp [20426] $56 - $60 1164%
Aither Health Contracted [320449] $64 1331%
Aither Health [20449] $64 1331%
Auxiant Contracted [320462] $64 1331%
Ebms Contracted [320493] $64 1331%
Edison Health Solutions Contracted [320502] $64 1331%
Federal Medical Center Contracted [320127] $64 1331%
Imagine 360 Contracted [320494] $64 1331%
Insurance System Inc Contracted [320465] $64 1331%
Mercy Benefit Admin Contracted [320251] $64 1331%
Mercy Benefit Admin [20251] $64 1331%
Point C Contracted [320238] $64 1331%
Preferred Health Plan Contracted [320522] $64 1331%
Reflect Health Contracted [320492] $64 1331%
Show-Me Health Administrators Contracted [320483] $64 1331%
Tri State Healthcare Coalition Contracted [320379] $64 1331%
Yuzu Health Contracted [320521] $64 1331%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 East Cherry Street, Troy, MO 63379
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals