CMS Price Transparency Data

Blood test, sodium

Facility: St David's South Austin Medical Center

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $81
  • Cash Discount Price: $342
  • vs. Medicare Baseline: 16.84x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at St David's South Austin Medical Center is $81. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $342. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 16.84x the Medicare baseline. Located in 901 West Ben White Blvd, Austin, TX.
Cash / Self-Pay
$342

Average discount available for prompt cash payment at this facility.

Insurance Median
$81

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: $342 (7110%)
Insurance Median: $81 (1684%)
Cash: $342 (7110% of Medicare)
Ins. Median: $81 (1684% 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 1684% of the Medicare baseline (a markup of 1584%). 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 $4 - $120 83%
Molina Healthcare $4 - $5 83%
St David’S Hospice $4 - $5 83%
United $4 - $169 83%
Aetna $5 104%
American Health Plan Of Texas $5 104%
Cigna $5 - $109 104%
Devoted Health $5 104%
Harbor Hospice $5 104%
Humana $5 104%
Imperial Insurance $5 104%
Odyssey Hospice $5 104%
Provider Partners Health Plan $5 104%
Pyramid Life $5 104%
Sendero $5 - $8 104%
Shared Health $5 104%
Superior Health Plan $5 - $64 104%
Texas Independent Health Plan $5 104%
Triwest Health Alliance $5 104%
Triwest Veterans $5 104%
Wellcare $5 104%
Wellmed $5 104%
Austin Fc $6 125%
Universal Health $6 125%
Amerigroup $7 146%
Naphcare $7 146%
Seven Corners $7 146%
Corvel Corporation $10 208%
UnitedHealthcare $12 - $376 249%
Oscar $13 - $15 270%
Moda $47 - $88 977%
Covenant Management Systems $58 - $108 1206%
Healthcare Highways $59 - $113 1227%
Imo Med - Select Network $61 - $113 1268%
Nomi Health $65 - $139 1351%
Moda Health $73 - $139 1518%
Evry Health $74 - $138 1538%
Texas Healthcare Foundation Heb $75 - $139 1559%
Texas Workforce Commission $79 - $147 1642%
Harbor Health Team $81 - $150 1684%
Averde Health $91 - $169 1892%
Comanche County $101 - $188 2100%
Emerging Therapy Solutions $101 - $259 2100%
National Choicecare $101 - $188 2100%
Healthsmart Preferred Care $111 - $301 2308%
Independent Medical Systems $111 - $207 2308%
Physicians Cooperative Of Texas $111 - $207 2308%
Prime Health $121 - $226 2516%
First Health $127 - $270 2640%
Coastal Comp Health Networks $131 - $244 2723%
National Health Care $131 - $244 2723%
Occunet $141 - $263 2931%
Texas Municipal League $141 - $263 2931%
Medcorp Southwest $152 - $282 3160%
Preferred Health Arrangement $152 - $282 3160%
Rockport Healthcare Group $162 - $338 3368%
Bce Emergis Corporation $182 - $338 3784%
Beech Street $182 - $338 3784%
Medical Control Network Solutions $182 - $338 3784%
Multiplan $182 - $338 3784%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 West Ben White Blvd, Austin, TX 78704
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals