CMS Price Transparency Data
Blood test, sodium
Facility: Diley Ridge Medical Center
Billing Code: 84295 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 84295
- Insurance Median: $12
- Cash Discount Price: $170
- vs. Medicare Baseline: 2.49x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Diley Ridge Medical Center is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $170. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 2.49x the Medicare baseline. Located in 7911 Diley Road, Canal Winchester, OH.
Cash / Self-Pay
$170
Average discount available for prompt cash payment at this facility.
Insurance Median
$12
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: $170 (3534%)
Insurance Median: $12 (249%)
Cash: $170 (3534% of Medicare)
Ins. Median: $12 (249% 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 249% of the Medicare baseline (a markup of 149%). 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.
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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 | $4 - $26 | 83% |
| Medicare (plans) | $4 - $5 | 83% |
| Blue Benefit Administrators Of Massachusetts | $5 | 104% |
| Blue Care Network | $5 | 104% |
| Blue Cross Blue Shield | $5 - $26 | 104% |
| Blue Distinction Transplant | $5 | 104% |
| Blue Shield - Ca | $5 | 104% |
| Blue Shield - Id (Regence) | $5 | 104% |
| Blue Shield - Ny Highmark Northeastern | $5 | 104% |
| Blue Shield - Ny Highmark Western | $5 | 104% |
| Blue Shield - Pa (Highmark) | $5 | 104% |
| Blue Shield - Wa (Regence) | $5 | 104% |
| Hospice Mount Carmel | $5 | 104% |
| Oscar | $5 | 104% |
| Rural Carrier Health Benefit Plan | $5 | 104% |
| The Health Plan | $5 - $17 | 104% |
| UnitedHealthcare | $5 - $55 | 104% |
| Enterprise Group Planning | $9 | 187% |
| Custom Design Benefits | $10 | 208% |
| Quality Care Partners | $11 | 229% |
| Access Health | $12 | 249% |
| Acclaim | $12 | 249% |
| Administrative Concepts | $12 | 249% |
| Allegeant | $12 | 249% |
| Allied Benefit Systems | $12 | 249% |
| American Family | $12 | 249% |
| American Healthcare Alliance | $12 | 249% |
| American National | $12 | 249% |
| American Republic | $12 | 249% |
| Amerihealth | $12 | 249% |
| Aultcare | $12 | 249% |
| Automated Benefit Services | $12 | 249% |
| Auxiant | $12 | 249% |
| Benefit Administrative Systems,Llc | $12 | 249% |
| Boon Chapman | $12 | 249% |
| Cam Administrative Services | $12 | 249% |
| Christian Brother Services | $12 | 249% |
| Christian Brothers Holy Cross | $12 | 249% |
| Claimchoice Adminstrators | $12 | 249% |
| Comprehensive Benefits | $12 | 249% |
| Continental Life Insurance | $12 | 249% |
| Coventry | $12 | 249% |
| Custom Benefit Administrators | $12 | 249% |
| Cypress Benefit Administrators | $12 | 249% |
| Employee Benefit Concepts | $12 | 249% |
| Employee Benefit Management | $12 | 249% |
| Forest County Potawatomi | $12 | 249% |
| Freedom Life Insurance Company | $12 | 249% |
| Geha | $12 - $55 | 249% |
| Gravie Admin Services | $12 | 249% |
| Group Administrators | $12 | 249% |
| Group Marketing Services | $12 | 249% |
| Group Pension Administrators | $12 | 249% |
| Guardian | $12 | 249% |
| Health America | $12 | 249% |
| Health Choices | $12 | 249% |
| Healthcare Management Admin | $12 | 249% |
| Healthez | $12 | 249% |
| Insight | $12 | 249% |
| Intercare | $12 | 249% |
| Jfp Benefit Management | $12 | 249% |
| Jp Farley Corporation | $12 | 249% |
| Key Benefit Administrator | $12 | 249% |
| Liberty Union Life Assurance Co | $12 | 249% |
| Lucent Health | $12 | 249% |
| Luminare Health | $12 | 249% |
| Magnacare | $12 | 249% |
| Medcost | $12 | 249% |
| Meritain | $12 | 249% |
| Mutual Health Services | $12 | 249% |
| Mutual Of Omaha | $12 | 249% |
| Ncas | $12 | 249% |
| Nippon Life Ins | $12 | 249% |
| Nova | $12 | 249% |
| Painters Union Insurance Fund | $12 | 249% |
| Physicians Mutual | $12 | 249% |
| Plumbers Local 98 Insurance Fund | $12 | 249% |
| Prairie States | $12 | 249% |
| Preferred One | $12 | 249% |
| Primary Physician Care | $12 | 249% |
| Professional Benefit Administrators | $12 | 249% |
| Secureone Preferred United Plans | $12 | 249% |
| Siho Insurance Services | $12 | 249% |
| Sisco Benefits | $12 | 249% |
| The Loomis Company | $12 | 249% |
| Trustmark Small Business Benefits | $12 | 249% |
| U Of M Health Plan | $12 | 249% |
| Unicare | $12 | 249% |
| Unified Group Services | $12 | 249% |
| Us Health And Life | $12 | 249% |
| Valenz | $12 | 249% |
| Varipro | $12 | 249% |
| Webtpa | $12 | 249% |
| Wps | $12 | 249% |
| Humana | $13 - $26 | 270% |
| Medben | $13 - $20 | 270% |
| First Health | $14 | 291% |
| Consociate | $16 | 333% |
| Health Ohio Network | $16 | 333% |
| Caresource | $19 | 395% |
| American Postal Workers Secondary | $20 | 416% |
| Cigna | $20 | 416% |
| Health Partners | $20 | 416% |
| Healthgram | $20 | 416% |
| Healthlink Inc | $20 | 416% |
| Luminare Health (Detroit) | $20 | 416% |
| Medical Benefits Mutual | $20 | 416% |
| Medical Mutual | $20 | 416% |
| Mvp | $20 | 416% |
| Ohio Health Choice | $20 | 416% |
| Ohio Ppo Connect | $20 | 416% |
| Osu Not Independent Choice | $20 | 416% |
| Priority Health | $20 | 416% |
| Ameriben | $21 | 437% |
| Medi Share | $21 | 437% |
| Multiplan | $21 | 437% |
| Ohiohealthy | $21 | 437% |
| Phcs | $21 | 437% |
| Philadelphia American Life Insurance | $21 | 437% |
| Twin Valley Psychiatric | $21 | 437% |
| Health Smart | $22 | 457% |
| Bccp | $26 | 541% |
| Medicaid / KanCare | $26 | 541% |
| Optima Health | $26 | 541% |
| Crime Victim Assistance | $632 | 13139% |
| Ohio Safe Program | $632 | 13139% |