CMS Price Transparency Data

Blood test, sodium

Facility: Adena Regional Medical Center

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $15
  • Cash Discount Price: $11
  • vs. Medicare Baseline: 3.12x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Adena Regional Medical Center is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 3.12x the Medicare baseline. Located in 272 Hospital Road, Chillicothe, OH.
Cash / Self-Pay
$11

Average discount available for prompt cash payment at this facility.

Insurance Median
$15

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: $11 (229%)
Insurance Median: $15 (312%)
Cash: $11 (229% of Medicare)
Ins. Median: $15 (312% 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 312% of the Medicare baseline (a markup of 212%). 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 - $35 104%
Buckeye Community Health Plan $5 104%
Care Source $5 104%
Gateway Health $5 104%
Humana $5 - $22 104%
Medical Mutual Of Ohio $5 - $15 104%
Medigold $5 104%
Molina $5 104%
UnitedHealthcare $5 - $12 104%
Molina Marketplace $8 166%
Care Source Just4Me $9 187%
Blue Cross Blue Shield $10 - $15 208%
Sidecar Health $13 270%
Cigna $14 - $16 291%
Ohio Ppo Connect $16 333%
The Health Plan $16 333%
First Health $18 - $35 374%
Ohio Health Choice $18 374%
Healthsmart $20 416%
Integrated Health Plan $22 457%
Multiplan/Private Healthcare Systems $22 457%
Three Rivers Network $22 457%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 272 Hospital Road, Chillicothe, OH 45601
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals