CMS Price Transparency Data

Blood test, sodium

Facility: Clarion Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $9
  • Cash Discount Price: $20
  • vs. Medicare Baseline: 1.87x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Clarion Hospital is $9. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 1.87x the Medicare baseline. Located in One Hospital Drive, Clarion, PA.
Cash / Self-Pay
$20

Average discount available for prompt cash payment at this facility.

Insurance Median
$9

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: $20 (416%)
Insurance Median: $9 (187%)
Cash: $20 (416% of Medicare)
Ins. Median: $9 (187% 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.

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
Martin'S Point - Usfhp $4 - $13 83%
Tricare $4 83%
Aetna $5 - $32 104%
American Health Plan $5 104%
Amerihealth $5 - $7 104%
Cigna $5 - $18 104%
Devoted Health Plan $5 - $14 104%
Gateway $5 - $13 104%
Geisinger $5 104%
Highmark $5 - $12 104%
Highmark Community Blue $5 104%
Jefferson Health Plan $5 104%
Medicare (plans) $5 104%
Pa Health & Wellness $5 104%
The Health Plan $5 - $11 104%
UnitedHealthcare $5 104%
Upmc $5 - $27 104%
Medicaid / KanCare $6 125%
Highmark - Ind.& Managed Care $11 - $12 229%
Peak Health $11 - $25 229%
Devon $27 561%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Drive, Clarion, PA 16214
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals