CMS Price Transparency Data

Blood test, sodium

Facility: Cook Childrens Medical Center Prosper

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84295
Insurance Median: $53
Cash Discount Price: $108
vs. Medicare Baseline: 11.02x Medicare

The contracted insurance negotiated median rate for a Blood test, sodium at Cook Childrens Medical Center Prosper is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $108. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 11.02x the Medicare baseline. Located in 4100 W University Drive, Prosper, TX.

Cash / Self-Pay

$108

Average discount available for prompt cash payment at this facility.

Insurance Median

$53

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: $108 (2245%)

Insurance Median: $53 (1102%)

Cash: $108 (2245% of Medicare)

Ins. Median: $53 (1102% 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 1102% of the Medicare baseline (a markup of 1002%). 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	$5 - $123	104%
Beacon	$5 - $78	104%
Blue Cross Blue Shield	$5 - $130	104%
El Paso Health First	$5 - $78	104%
Firstcare	$5 - $115	104%
Health Plan W. Uhrip	$5	104%
Health Plan W/O Uhrip	$5 - $78	104%
Superior Health	$5	104%
Tx Children Health	$5 - $78	104%
United Community	$5 - $53	104%
Wellpoint	$5	104%
UnitedHealthcare	$64 - $123	1331%
S&W Health	$121	2516%
Cigna	$123	2557%
Healthscope	$123	2557%
Imagine Health	$123	2557%
Humana	$126 - $127	2620%
Multiplan	$126	2620%
First Health	$127	2640%
Galaxy Health	$130	2703%
Healthsmart	$130	2703%
Usamco	$133	2765%

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 $108.
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 Cook Childrens Medical Center Prosper 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.