CMS Price Transparency Data

Blood test, sodium

Facility: St Peter's Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $11
  • Cash Discount Price: $258
  • vs. Medicare Baseline: 2.29x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at St Peter's Hospital is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $258. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 2.29x the Medicare baseline. Located in 315 South Manning Boulevard, Albany, NY.
Cash / Self-Pay
$258

Average discount available for prompt cash payment at this facility.

Insurance Median
$11

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: $258 (5364%)
Insurance Median: $11 (229%)
Cash: $258 (5364% of Medicare)
Ins. Median: $11 (229% 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 229% of the Medicare baseline (a markup of 129%). 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 - $16 104%
Albany County Correctional Facility $5 104%
Blue Cross Blue Shield $5 - $22 104%
Eddy Seniorcare Pace $5 104%
Hudson Headwaters Pace $5 104%
Medicaid / KanCare $5 - $333 104%
Medicare (plans) $5 - $96 104%
Mvp $5 104%
Nascentia Health Options $5 104%
Nascentia Health Plus $5 104%
Secure Horizons Ma Pffs $5 104%
UnitedHealthcare $5 - $96 104%
Healthbridge Financial $8 166%
Iha Idaho Self Pay Informational $8 166%
Iha Indiana Self Pay Informational $8 166%
Iha Iowa Self Pay Informational $8 166%
Rx Aquinata Marywood $8 166%
Rx Cmh Discharge $8 166%
Rx Detroit Formulary $8 166%
Rx First Fill Program $8 166%
Rx Harbor Homecare $8 166%
Rx Lipc/Mchp $8 166%
Rx Lipc/Mchp Copay $8 166%
Rx Mcauley Clinic $8 166%
Rx Net Rx $8 166%
Rx Ny Naloxone Copay $8 166%
Rx Patient Support Program $8 166%
Fidelis Care $9 187%
Wellpath $11 229%
Harvard Pilgrim Healthcare $12 249%
Bcn Domestic $13 270%
Blue Care Network $13 270%
Unicare $13 270%
1199 National Benefit Fund $16 333%
Allied Benefit Systems $16 333%
Asr Health Benefits $16 333%
Christian Brother Services $16 333%
Geha $16 333%
Lucent Health $16 333%
Luminare Health $16 333%
Medical Mutual $16 333%
Meritain $16 333%
Trustmark Small Business Benefits $16 333%
Blue Shield - Ny Highmark Northeastern $18 - $22 374%
Blue Shield - Ca $22 457%
Blue Shield - Id (Regence) $22 457%
Blue Shield - Ny Highmark Western $22 457%
Blue Shield - Pa (Highmark) $22 457%
Blue Shield - Wa (Regence) $22 457%
Allegiance $43 894%
American Postal Workers Secondary $43 894%
Cigna $43 894%
Diversified Administrators $43 894%
Health Partners $43 894%
Priority Health $43 894%
Tufts Health Plan $43 894%
Webtpa $43 894%
Emblem Health $48 998%
Nova $48 998%
Carelon Behavioral Health $72 1497%
Galaxy Health Network $77 1601%
Health Republic $82 1705%
Independent Health $82 1705%
Magnacare $82 1705%
Health New England $86 1788%
Multiplan $86 1788%
Phcs $86 1788%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 315 South Manning Boulevard, Albany, NY 12208
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals