CMS Price Transparency Data

Blood test, sodium

Facility: Cleveland Clinic Children's Hospital for Rehab

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84295
Insurance Median: $19
Cash Discount Price: $21
vs. Medicare Baseline: 3.95x Medicare

The contracted insurance negotiated median rate for a Blood test, sodium at Cleveland Clinic Children's Hospital for Rehab is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 3.95x the Medicare baseline. Located in 2801 Martin Luther King, Jr Drive, Cleveland, OH.

Cash / Self-Pay

$21

Average discount available for prompt cash payment at this facility.

Insurance Median

$19

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: $21 (437%)

Insurance Median: $19 (395%)

Cash: $21 (437% of Medicare)

Ins. Median: $19 (395% 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 395% of the Medicare baseline (a markup of 295%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Oscar	$10 - $12	208%
Aultcare	$11	229%
Amish Community Aid Plan	$14 - $16	291%
Cigna	$14 - $26	291%
Ohcp	$16	333%
Summacare	$16	333%
UnitedHealthcare	$16 - $23	333%
Buckeye	$17 - $21	353%
Blue Cross Blue Shield	$18 - $24	374%
Caresource	$18	374%
Healthsmart	$18	374%
Molina	$18	374%
Paramount	$18	374%
United	$18	374%
Amerihealth	$19	395%
Php	$19	395%
Phphi	$19	395%
The Health Plan	$19	395%
Upmc	$19	395%
Aetna	$21 - $32	437%
Gms	$22	457%
Medical Benefit Corp	$22	457%
Quality Care Partners	$22	457%
Cc Ehp	$23	478%
Consociate Health	$24	499%
Ohio Healthy	$26	541%
Managed Care Services	$29	603%
Multiplan	$29	603%
Three Rivers	$29	603%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $21.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84295.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Cleveland Clinic Children's Hospital for Rehab is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 84295.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.