CMS Price Transparency Data

Blood test, sodium

Facility: SSM Health St Anthony Hospital - Oklahoma City

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84295
Insurance Median: $6
Cash Discount Price: $30
vs. Medicare Baseline: 1.25x Medicare

The contracted insurance negotiated median rate for a Blood test, sodium at SSM Health St Anthony Hospital - Oklahoma City is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 1.25x the Medicare baseline. Located in 1000 North Lee Avenue, Oklahoma City, OK.

Cash / Self-Pay

$30

Average discount available for prompt cash payment at this facility.

Insurance Median

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: $30 (624%)

Insurance Median: $6 (125%)

Cash: $30 (624% of Medicare)

Ins. Median: $6 (125% 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.

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
Cigna	$3	62%
Blue Cross Blue Shield	$5	104%
Community Care	$5 - $12	104%
Humana	$5	104%
UnitedHealthcare	$5 - $6	104%
Ambetter / Centene	$6	125%
Healthchoice	$6	125%
Kempton	$6 - $9	125%
Oscar	$6	125%
Medica	$7	146%
Global Health	$10 - $11	208%

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 $30.
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 SSM Health St Anthony Hospital - Oklahoma City 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.