CMS Price Transparency Data

Blood test, sodium

Facility: Hospital Metropolitano Dr Susoni

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $7
  • Cash Discount Price: $30
  • vs. Medicare Baseline: 1.46x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Hospital Metropolitano Dr Susoni is $7. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 1.46x the Medicare baseline. Located in Calle Palma Num 55, Arecibo, PR.
Cash / Self-Pay
$30

Average discount available for prompt cash payment at this facility.

Insurance Median
$7

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: $30 (624%)
Insurance Median: $7 (146%)
Cash: $30 (624% of Medicare)
Ins. Median: $7 (146% 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
Humana $6 - $7 125%
Aetna $7 146%
Ch $7 146%
Cigna $7 146%
Comerciales $7 146%
Mcs $7 - $8 146%
Medicare (plans) $7 146%
Mso $7 146%
Prossam $7 146%
Tricare $7 146%
Triple S $7 - $8 146%
Va $7 146%
Aarp $8 166%
Acaa $8 166%
Bl $8 166%
First Medical $8 166%
Hospicio $8 166%
Mapfre $8 166%
Mc $8 166%
Plan De Salud Menonita $8 166%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Calle Palma Num 55, Arecibo, PR 00612
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals