CMS Price Transparency Data

Blood test, sodium

Facility: Lancaster General Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $11
  • Cash Discount Price: $35
  • vs. Medicare Baseline: 2.29x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Lancaster General Hospital is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 2.29x the Medicare baseline. Located in 555 North Duke Street, Lancaster, PA.
Cash / Self-Pay
$35

Average discount available for prompt cash payment at this facility.

Insurance Median
$11

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: $35 (728%)
Insurance Median: $11 (229%)
Cash: $35 (728% of Medicare)
Ins. Median: $11 (229% 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 229% of the Medicare baseline (a markup of 129%). 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
Blue Cross Blue Shield $2 - $30 42%
Tricare $4 83%
Aetna $5 - $21 104%
Albright Life $5 104%
Amerihealth Caritas $5 - $6 104%
Cigna $5 - $29 104%
Coatesville Va $5 104%
Devoted Health $5 104%
Health Partners Mcr Advantage $5 104%
Highmark $5 - $35 104%
Hospice Generic $5 104%
Lebanon Veterans Hospital $5 104%
Medicare (plans) $5 104%
Pa Health And Wellness Mcr $5 104%
UnitedHealthcare $5 - $30 104%
Lancaster County Mh $6 125%
Medicaid / KanCare $6 - $11 125%
Elap Employees $7 146%
Hospice And Community Care $7 146%
Gateway $8 166%
Old Order Group $9 - $11 187%
Oscar Health Plan $9 187%
Lancashire Hall $10 - $35 208%
Lg Coresource/Lg Eliance $10 208%
Nursing Home Op Services $10 208%
Highmark Commercial Preferred $11 - $35 229%
Upmc For You $11 229%
Affilia Home Health $14 - $35 291%
Claim Watcher Plus $14 291%
Masonic Homes $15 - $35 312%
Claim Watcher $16 333%
Eliance Health Solutions $16 - $22 333%
Highmark Commercial Non-Preferred $17 - $35 353%
Elap Other Groups $18 374%
Preferred Healthcare $21 - $30 437%
Ehp $29 603%
Upmc Commercial $29 - $30 603%
Devon $30 624%
Geisinger Commercial $30 624%
Intergroup Services $30 624%
Medi-Share Christian Care $33 686%
Commercial Generic $35 728%
Magellan $35 728%
United Behavioral Health $35 728%
Value Options $35 728%
Workers Compensation $35 728%
Gift Of Life Donor Program $13,500 280665%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 555 North Duke Street, Lancaster, PA 17602
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals