CMS Price Transparency Data

Blood test, sodium

Facility: North Austin Medical Center

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $29
  • Cash Discount Price: $283
  • vs. Medicare Baseline: 6.03x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at North Austin Medical Center is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $283. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 6.03x the Medicare baseline. Located in 12221 Mopac Expressway North, Austin, TX.
Cash / Self-Pay
$283

Average discount available for prompt cash payment at this facility.

Insurance Median
$29

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: $283 (5884%)
Insurance Median: $29 (603%)
Cash: $283 (5884% of Medicare)
Ins. Median: $29 (603% 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 603% of the Medicare baseline (a markup of 503%). 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%
Superior Health Plan $4 - $69 83%
United $4 - $183 83%
Aetna $5 104%
American Health Plan Of Texas $5 104%
Cigna $5 - $14 104%
Devoted Health $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%
Texas Independent Health Plan $5 104%
Triwest Health Alliance $5 104%
Triwest Healthcare Alliance $5 104%
UnitedHealthcare $5 - $183 104%
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%
Oscar $13 - $15 270%
Moda $18 - $95 374%
Covenant Management Systems $22 - $117 457%
Healthcare Highways $22 - $122 457%
Imo Med - Select Network $22 - $122 457%
Nomi Health $24 - $150 499%
Moda Health $27 - $150 561%
Evry Health $28 - $149 582%
Texas Healthcare Foundation Heb $28 - $150 582%
Texas Workforce Commission $29 - $158 603%
Harbor Health Team $30 - $162 624%
Averde Health $34 - $183 707%
Comanche County $38 - $203 790%
National Choicecare $38 - $203 790%
Healthsmart Preferred Care $41 - $325 852%
Independent Medical Systems $41 - $223 852%
Physicians Cooperative Of Texas $41 - $223 852%
Prime Health $45 - $244 936%
First Health $47 - $288 977%
Coastal Comp Health Networks $49 - $264 1019%
National Health Care $49 - $264 1019%
Texas Municipal League $52 - $284 1081%
Medcorp Southwest $56 - $304 1164%
Rockport Healthcare Group $60 - $365 1247%
Bce Emergis Corporation $68 - $365 1414%
Beech Street $68 - $365 1414%
Medical Control Network Solutions $68 - $365 1414%
Multiplan $68 - $365 1414%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12221 Mopac Expressway North, Austin, TX 78758
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals