CMS Price Transparency Data

Blood test, sodium

Facility: Penn Presbyterian Medical Center

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $59
  • Cash Discount Price: $185
  • vs. Medicare Baseline: 12.27x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Penn Presbyterian Medical Center is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $185. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 12.27x the Medicare baseline. Located in 51 North 39Th Street, Philadelphia, PA.
Cash / Self-Pay
$185

Average discount available for prompt cash payment at this facility.

Insurance Median
$59

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: $185 (3846%)
Insurance Median: $59 (1227%)
Cash: $185 (3846% of Medicare)
Ins. Median: $59 (1227% 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 1227% of the Medicare baseline (a markup of 1127%). 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 - $185 42%
Ibc Commercial Hpn $2 42%
Keystone Hmo Proactive $2 42%
Cigna $3 - $59 62%
Aetna $5 - $185 104%
Clover Health Plan $5 104%
Geisinger Health Plan $5 - $15 104%
Health Partners $5 - $185 104%
Humana $5 - $148 104%
Ibc $5 104%
Keystone First $5 104%
Medicare (plans) $5 104%
Pa Health And Wellness $5 - $8 104%
Penn Life (Living Independently For Elders) $5 104%
Philadelphia Va Medical Center $5 104%
Tricare $5 104%
UnitedHealthcare $5 - $185 104%
Upmc $5 - $185 104%
Us Family Health Plan $5 104%
Gateway Health Plan $6 125%
Medicaid / KanCare $6 - $185 125%
Pa Medical Assistance $6 125%
Elap $7 146%
Claims Watcher $8 - $9 166%
Keystone Mercy Health Plan $8 - $185 166%
Oscar Health Plan $8 166%
Centivo $9 187%
Elap Services $9 187%
Highmark $10 208%
Penn Global Medicine $13 270%
Horizon Nj Health $31 - $33 644%
Pgm - Regie De L'Assurance Maladie Quebec $43 894%
Preferred Health Care Eliance $46 956%
Pgm - Kuwait Defense $65 - $83 1351%
Devon $70 - $83 1455%
Qualcare $70 1455%
Coventry $74 - $94 1538%
Pgm - Chop $74 1538%
Wissahickon Hospice $74 1538%
Healthamerica/Coventry $83 - $91 1726%
Olympus $88 1830%
First Health Global $92 1913%
Urn-Cancer Resource Services $92 1913%
Health Net $111 2308%
Pgm - Royal Embassy Of Saudi Arabia $111 2308%
Pgm - Embassy Of Qatar $120 2495%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $120 2495%
Pgm - Embassy Of The United Emirates/Ipc $130 2703%
Devon Health Services Inc $148 3077%
Health America/Ccn $148 3077%
Intergroup $148 3077%
Pgm - Kuwait Health Division $148 3077%
Pgm - Kuwait Oil $148 3077%
Preferred Care $148 3077%
Commercial Other $185 3846%
International Pfs $185 3846%
Magellan $185 3846%
Quest Behavioral Health $185 3846%
United Behavioral Health $185 3846%
Workers Compensation $185 3846%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 51 North 39Th Street, Philadelphia, PA 19104
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals