CMS Price Transparency Data

Blood test, sodium

Facility: Children's Hospital of Philadelphia

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84295
Insurance Median: $144
Cash Discount Price: $377
vs. Medicare Baseline: 29.94x Medicare

The contracted insurance negotiated median rate for a Blood test, sodium at Children's Hospital of Philadelphia is $144. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $377. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 29.94x the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.

Cash / Self-Pay

$377

Average discount available for prompt cash payment at this facility.

Insurance Median

$144

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: $377 (7838%)

Insurance Median: $144 (2994%)

Cash: $377 (7838% of Medicare)

Ins. Median: $144 (2994% 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 2994% of the Medicare baseline (a markup of 2894%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Geisinger Medical Assistance	$9	187%
Highmark Wholecare	$10	208%
Horizon Nj Health	$14	291%
Medicaid / KanCare	$47 - $77	977%
UnitedHealthcare	$48 - $257	998%
Health Partners	$54 - $88	1123%
Aetna	$68 - $234	1414%
Upmc Medical Assistance	$78 - $128	1622%
Keystone First Chip	$89 - $145	1850%
Keystone Health Plan East	$91 - $148	1892%
Blue Cross Blue Shield	$101 - $187	2100%
Geisinger Health Plan Commercial	$126 - $206	2620%
Jefferson Health Plans	$136 - $221	2827%
Cigna	$144 - $234	2994%
Highmark	$144 - $234	2994%
Qualcare	$158 - $257	3285%
First Health Network	$187 - $304	3888%
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics	$230 - $374	4782%
Private Health Care Systems	$230 - $374	4782%
Choice Care Network	$259 - $421	5385%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $377.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84295.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Children's Hospital of Philadelphia is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 84295.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.