CMS Price Transparency Data

Blood test, sodium

Facility: Adventist Health Portland

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $18
  • Cash Discount Price: $60
  • vs. Medicare Baseline: 3.74x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Adventist Health Portland is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $60. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 3.74x the Medicare baseline. Located in 10123 Se Market Street, Portland, OR.
Cash / Self-Pay
$60

Average discount available for prompt cash payment at this facility.

Insurance Median
$18

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: $60 (1247%)
Insurance Median: $18 (374%)
Cash: $60 (1247% of Medicare)
Ins. Median: $18 (374% 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 374% of the Medicare baseline (a markup of 274%). 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 $1 - $12 21%
Healthnet Epo/Pos/Ppo $1 - $12 21%
Healthnet Hmo/Pos - All Other Plans $1 - $12 21%
Pacific Source Comm - All Plans $1 - $12 21%
Providence Hp - All Plans $1 - $12 21%
Care Oregon - All Plans $4 83%
Ods - All Plans $4 83%
Humana $5 104%
Kaiser Mcr Adv $5 104%
Moda Mcr Adv $5 104%
UnitedHealthcare $5 - $368 104%
Healthcare Resources - All Plans $6 - $55 125%
Healthnet Mcr Adv $6 125%
Ah Employee Health Plan - All Plans $9 187%
Workers Comp $9 - $85 187%
Moda Conn Oebb/Syn Pebb $10 208%
Cigna $11 229%
Moda Affinity - All Other Plans $11 229%
Regence Ohsu Plus $12 249%
Bc Premera First - All Plans $13 - $122 270%
Kaiser - All Other Plans $13 270%
Regence - All Other Plans $13 270%
Moda Select $15 312%
Worldventure - All Plans $16 - $147 333%
Moda Connexus $17 353%
Regence Preferred Mcr Adv $17 - $160 353%
First Choice - All Plans $18 - $170 374%
Moda Synergy $18 374%
Multiplan - All Plans $20 - $184 416%
Phcs - All Plans $20 - $184 416%
Regence Mcr Adv $20 - $186 416%
First Health-Coventry - All Plans $21 - $196 437%
Health Payors Organization Ltd- All Plans $23 - $220 478%
National Provider Network - All Plans $23 - $216 478%
Moda Ohsu Ppo/Epo/Hmc $47 - $441 977%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10123 Se Market Street, Portland, OR 97216
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals