CMS Price Transparency Data

Blood test, sodium

Facility: Texas Childrens Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84295
Insurance Median: $43
Cash Discount Price: $49
vs. Medicare Baseline: 8.94x Medicare

The contracted insurance negotiated median rate for a Blood test, sodium at Texas Childrens Hospital is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 8.94x the Medicare baseline. Located in 6621 Fannin Street, Houston, TX.

Cash / Self-Pay

$49

Average discount available for prompt cash payment at this facility.

Insurance Median

$43

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: $49 (1019%)

Insurance Median: $43 (894%)

Cash: $49 (1019% of Medicare)

Ins. Median: $43 (894% 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 894% of the Medicare baseline (a markup of 794%). 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
Driscoll Children'S Health Plan Mcd	$5	104%
Superior Chip	$5	104%
Community Health Choice	$8 - $54	166%
First Care Health Plan	$16 - $54	333%
UnitedHealthcare	$16 - $54	333%
Molina Mcd	$18 - $26	374%
Blue Cross Blue Shield	$21 - $54	437%
Community First Health Plan Mcd	$24 - $34	499%
Cook Children'S Health Plan	$24 - $34	499%
Cigna	$35 - $54	728%
Aetna	$39 - $54	811%
Kelseycare	$40 - $55	832%
Healthsmart	$43 - $60	894%
Evolutions Healthcare	$46 - $64	956%
First Health	$54 - $81	1123%
Multiplan	$55 - $76	1143%
Galaxy Health Network	$58 - $81	1206%

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 $49.
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 Texas Childrens Hospital 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.