CMS Price Transparency Data

Blood test, sodium

Facility: Childrens Medical Center Plano

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84295
Insurance Median: $95
Cash Discount Price: $111
vs. Medicare Baseline: 19.75x Medicare

The contracted insurance negotiated median rate for a Blood test, sodium at Childrens Medical Center Plano is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $111. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 19.75x the Medicare baseline. Located in 7601 Preston Road, Plano, TX.

Cash / Self-Pay

$111

Average discount available for prompt cash payment at this facility.

Insurance Median

$95

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: $111 (2308%)

Insurance Median: $95 (1975%)

Cash: $111 (2308% of Medicare)

Ins. Median: $95 (1975% 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 1975% of the Medicare baseline (a markup of 1875%). 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
Aetna	$4 - $118	83%
Humana	$4 - $127	83%
Medicaid / KanCare	$4	83%
Oklahoma Complete Health	$4	83%
Superior Health Plan	$5	104%
Firstcare Health	$29 - $39	603%
Wellpoint	$37 - $49	769%
Molina Healthcare	$40 - $54	832%
Parkland Community	$42 - $56	873%
Texas Children'S Health Plan	$42 - $56	873%
Cookchildren'S Health Plan	$43 - $57	894%
Carelon	$47 - $83	977%
Blue Cross Blue Shield	$50 - $115	1040%
UnitedHealthcare	$67 - $127	1393%
Methodist	$72 - $96	1497%
Cigna	$83 - $117	1726%
Employers Health Network	$88 - $118	1830%
Imagine Health	$88 - $118	1830%
Scott & White	$89 - $120	1850%
Txp Emerging Therapy Solutions	$89 - $120	1850%
Healthsmart	$92 - $144	1913%
Healthscope Benefit Solutions	$94 - $127	1954%
Phcs	$94 - $127	1954%
Quiktrip (Qt)	$94 - $127	1954%
Txp Interlink	$94 - $127	1954%
Coventry Health	$101 - $135	2100%
Equifax Healthcare	$107 - $144	2225%
Multiplan	$107 - $144	2225%
Usa Managed Care	$117 - $157	2432%
Galaxy Health	$122 - $164	2536%

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 $111.
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 Childrens Medical Center Plano 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.