CMS Price Transparency Data

Blood test, sodium

Facility: Atrium Health Pineville

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84295
Insurance Median: $37
Cash Discount Price: $42
vs. Medicare Baseline: 7.69x Medicare

The contracted insurance negotiated median rate for a Blood test, sodium at Atrium Health Pineville is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 7.69x the Medicare baseline. Located in 10628 Park Rd, Charlotte, NC.

Cash / Self-Pay

$42

Average discount available for prompt cash payment at this facility.

Insurance Median

$37

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: $42 (873%)

Insurance Median: $37 (769%)

Cash: $42 (873% of Medicare)

Ins. Median: $37 (769% 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 769% of the Medicare baseline (a markup of 669%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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 - $70	104%
Cigna	$5 - $57	104%
Humana	$5	104%
UnitedHealthcare	$5 - $40	104%
Alliance	$6 - $9	125%
Amerihealth Caritas	$6 - $9	125%
Carolina Complete Health	$6 - $9	125%
Healthy Blue	$6 - $9	125%
Ortho Carolina	$6	125%
Partners	$6 - $8	125%
Trillium	$6 - $9	125%
Vaya	$6 - $9	125%
Wellcare	$6 - $9	125%
Ambetter / Centene	$25 - $31	520%
Blue Cross Blue Shield	$25 - $33	520%
Employers Health Network	$38 - $45	790%
Physician Reach Out	$42	873%
Medcost	$46 - $51	956%
Magellan	$51	1060%
Gmmi	$55	1143%
Quik Trip	$55	1143%
Choicecare	$61 - $63	1268%
Healthgram	$68	1414%
Provider Select	$69 - $76	1435%
First Health	$70	1455%
Private Health Care Systems	$70	1455%
Beechstreet	$76	1580%
Multiplan	$78	1622%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $42.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84295.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Atrium Health Pineville is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 84295.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.