CMS Price Transparency Data

Blood test, sodium

Facility: Cincinnati Children's Hospital Medical Center

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $63
  • Cash Discount Price: $35
  • vs. Medicare Baseline: 13.10x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Cincinnati Children's Hospital Medical Center is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 13.10x the Medicare baseline. Located in 3333 Burnet Avenue, Cincinnati, OH.
Cash / Self-Pay
$35

Average discount available for prompt cash payment at this facility.

Insurance Median
$63

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: $35 (728%)
Insurance Median: $63 (1310%)
Cash: $35 (728% of Medicare)
Ins. Median: $63 (1310% 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 1310% of the Medicare baseline (a markup of 1210%). 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 - $65 104%
Humana $5 - $18 104%
Passport_Ky $5 104%
United_Health_Care_Ky $5 104%
Wellcare_Ky $5 104%
Blue Cross Blue Shield $6 - $67 125%
Mhs_In $6 125%
Caresource_In $7 146%
Caresource_Oh $18 374%
United_Health_Care_Oh $18 374%
Amerihealth_Caritas_Oh $19 395%
Molina_Oh $19 395%
Buckeye_Oh $20 416%
Caresource_Oh_Insurance $33 686%
Cigna $33 - $65 686%
Medical_Mutual_Of_Ohio_Insurance $42 - $65 873%
Point_Comfort_Insurance $44 915%
Margaret_Mary_Health_Insurance $53 1102%
Parkview_Signature_Care_Insurance $53 1102%
United_Health_Care_Insurance $61 1268%
Health_Ohio_Network_Insurance $62 - $65 1289%
Custom_Design_Benefits_Insurance $65 1351%
Health_Smart_Preferred_Insurance $65 1351%
Medical_Benefit_Administrators_Insurance $65 1351%
Ohio_Health_Choice_Insurance $65 1351%
Private_Health_Care_Systems_Insurance $65 1351%
Beechstreet_Insurance $67 1393%
First_Health_Group_Insurance $67 1393%
Health_Link_Insurance $67 1393%
Evolutions_Health_Care_Systems $68 1414%
Galaxy_Health_Insurance $68 1414%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3333 Burnet Avenue, Cincinnati, OH 45229
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens