CMS Price Transparency Data

Blood test, sodium

Facility: Highlands Cashiers Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $69
  • Cash Discount Price: $155
  • vs. Medicare Baseline: 14.35x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Highlands Cashiers Hospital is $69. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $155. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 14.35x the Medicare baseline. Located in 190 Hospital Drive, Highlands, NC.
Cash / Self-Pay
$155

Average discount available for prompt cash payment at this facility.

Insurance Median
$69

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: $155 (3222%)
Insurance Median: $69 (1435%)
Cash: $155 (3222% of Medicare)
Ins. Median: $69 (1435% 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 1435% of the Medicare baseline (a markup of 1335%). 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
Amerihealth $6 125%
Apex Health $31 644%
Cigna $51 - $69 1060%
Blue Cross Blue Shield $53 - $56 1102%
United $54 - $94 1123%
Wellcare $54 1123%
Partners Health Management $55 1143%
Vaya Health $55 1143%
Amerihealth Caritas $59 1227%
Caresource $68 1414%
Medcost $73 - $88 1518%
Magellan $93 1933%
Magellan Behavioral Health $93 1933%
Aetna $113 2349%
Multiplan $124 2578%
Avalon Administrative Services $132 2744%
Prime Health $137 - $140 2848%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 190 Hospital Drive, Highlands, NC 28741
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals