CMS Price Transparency Data

Blood test, sodium

Facility: North Carolina Baptist Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $17
  • Cash Discount Price: $26
  • vs. Medicare Baseline: 3.53x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at North Carolina Baptist Hospital is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $26. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 3.53x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.
Cash / Self-Pay
$26

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

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: $26 (541%)
Insurance Median: $17 (353%)
Cash: $26 (541% of Medicare)
Ins. Median: $17 (353% 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 353% of the Medicare baseline (a markup of 253%). 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
Aetna $5 - $45 104%
Apex $5 104%
Blue Cross Blue Shield $5 - $20 104%
Cigna $5 - $32 104%
Devoted $5 104%
Healthteam $5 104%
Humana $5 - $29 104%
Medicare (plans) $5 104%
UnitedHealthcare $5 - $18 104%
Wellcare $5 - $9 104%
Liberty $6 125%
Medcost $8 - $35 166%
Alliance $9 187%
Amerihealth $9 - $13 187%
Carolina Complete $9 187%
Health Blue $9 187%
Partners $9 187%
Trillium $9 187%
Vaya $9 187%
Ambetter / Centene $11 - $12 229%
Oscar $15 - $19 312%
Directnet $30 - $31 624%
Cone Health $35 - $37 728%
Healthgram $35 - $37 728%
First Carolina Care $40 - $42 832%
Private Healthcare Systems $41 - $43 852%
Multiplan $45 - $48 936%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Medical Center Boulevard, Winston-Salem, NC 27157
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals