CMS Price Transparency Data

Blood test, sodium

Facility: Portsmouth Regional Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $47
  • Cash Discount Price: $117
  • vs. Medicare Baseline: 9.77x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Portsmouth Regional Hospital is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $117. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 9.77x the Medicare baseline. Located in 333 Borthwick Ave, Portsmouth, NH.
Cash / Self-Pay
$117

Average discount available for prompt cash payment at this facility.

Insurance Median
$47

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: $117 (2432%)
Insurance Median: $47 (977%)
Cash: $117 (2432% of Medicare)
Ins. Median: $47 (977% 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 977% of the Medicare baseline (a markup of 877%). 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 Caritas $4 83%
Well Sense Health Plan $4 83%
Aetna $5 - $77 104%
Blue Cross Blue Shield $5 - $54 104%
Cigna $5 - $25 104%
Evernorth Behavioral Health $5 104%
Humana $5 104%
Martin'S Point Health $5 104%
Sierra Military Health $5 104%
United $5 - $80 104%
United Behavioral Health $5 104%
United Va Ccn $5 104%
Ambetter / Centene $9 187%
Harvard Pilgrim $20 - $52 416%
Maine Community Health $35 - $64 728%
Tufts Health Plan $42 - $69 873%
Mvp Health Plan $78 - $85 1622%
Corvel $81 - $87 1684%
Evernorth $90 - $97 1871%
Mutual Of Omaha $90 - $97 1871%
Multiplan $91 - $98 1892%
First Health $102 - $110 2121%
Healthcare Value Mgmt $102 - $110 2121%
Oxford Health Plans $106 - $115 2204%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 333 Borthwick Ave, Portsmouth, NH 03801
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals