CMS Price Transparency Data

Blood test, sodium

Facility: Mercy Hospital Tishomingo Inc

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $31
  • Cash Discount Price: $41
  • vs. Medicare Baseline: 6.44x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Mercy Hospital Tishomingo Inc is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $41. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 6.44x the Medicare baseline. Located in 1000 South Byrd St, Tishomingo, OK.
Cash / Self-Pay
$41

Average discount available for prompt cash payment at this facility.

Insurance Median
$31

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: $41 (852%)
Insurance Median: $31 (644%)
Cash: $41 (852% of Medicare)
Ins. Median: $31 (644% 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 644% of the Medicare baseline (a markup of 544%). 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 $4 - $42 83%
Humana $4 - $50 83%
Medicaid / KanCare $4 - $19 83%
Health Choice Contracted [320166] $6 125%
Blue Cross Blue Shield $17 - $30 353%
Ambetter / Centene $19 395%
Home State Health Plan Contracted [320187] $19 395%
Novasys Contracted [320285] $19 395%
Webtpa Contracted [320417] $26 541%
Medicare (plans) $29 - $40 603%
Cherokee Nation Health Serv Contracted [320066] $30 624%
Cross Timbers Hospice [20098] $30 624%
Dept Of Veteran Affairs Contracted [320106] $30 624%
Elara Caring Aspire Hospice Contracted [320433] $30 624%
Elara Caring Aspire Hospice [20433] $30 624%
Halo Hcr Inc Hospice Contracted [320432] $30 624%
Halo Hcr Inc Hospice [20432] $30 624%
Independent Health [20197] $30 624%
Indian Health Service Contracted [320198] $30 624%
Kindful Hospice Contracted [320434] $30 624%
Kindful Hospice [20434] $30 624%
Medical Associates Health [20444] $30 624%
Mercy Hospice Okc [20252] $30 624%
Provider Partners Health Plans Contracted [320450] $30 624%
Qual Choice Contracted [320325] $30 624%
Tribute Health Plan Mcr Contracted [320338] $30 624%
Tricare $30 624%
UnitedHealthcare $30 - $50 624%
Cigna $31 - $47 644%
Globalhealth Contracted [320145] $31 644%
Aither Health Contracted [320449] $38 - $54 790%
Mercy Benefit Admin Contracted [320251] $38 - $54 790%
Quik Trip Contracted [320447] $38 790%
Show-Me Health Administrators Contracted [320483] $38 790%
Medica Contracted [320239] $40 832%
First Health Contracted [320128] $42 873%
Osma Health Contracted [320292] $44 915%
Benefit Management Contracted [320052] $47 - $57 977%
Healthcare Highways Plus Contracted [320175] $47 977%
Private Health Care Systems Contracted [320320] $47 - $50 977%
Multiplan Contracted [320270] $50 - $57 1040%
United Medical Resources Contracted [320454] $50 1040%
Auxiant Contracted [320462] $54 1123%
Ebms Contracted [320493] $54 1123%
Healthlink Contracted [320179] $54 1123%
Imagine 360 Contracted [320494] $54 1123%
Preferred Community Choice Contracted [320311] $54 1123%
Reflect Health Contracted [320492] $54 1123%
Yuzu Health Contracted [320521] $54 1123%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 South Byrd St, Tishomingo, OK 73460
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals