CMS Price Transparency Data

Blood test, sodium

Facility: Baylor Scott & White Medical Center Pflugerville

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84295
Insurance Median: $35
Cash Discount Price: $58
vs. Medicare Baseline: 7.28x Medicare

The contracted insurance negotiated median rate for a Blood test, sodium at Baylor Scott & White Medical Center Pflugerville is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $58. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 7.28x the Medicare baseline. Located in 2600 East Pflugerville Parkway, Pflugerville, TX.

Cash / Self-Pay

$58

Average discount available for prompt cash payment at this facility.

Insurance Median

$35

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: $58 (1206%)

Insurance Median: $35 (728%)

Cash: $58 (1206% of Medicare)

Ins. Median: $35 (728% 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 728% of the Medicare baseline (a markup of 628%). 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
American Health Plan	$5	104%
Baylor Scott & White Health Plan	$5 - $42	104%
Corvel	$5	104%
Healthspring	$5	104%
Humana	$5 - $68	104%
Prime Health Services	$5	104%
Procare Advantage	$5	104%
Superior Health Plan	$5 - $17	104%
Triwest	$5	104%
UnitedHealthcare	$6 - $11	125%
Sedgwick	$7	146%
Blue Cross Blue Shield	$23 - $28	478%
Cigna	$46 - $54	956%
Aetna	$53	1102%
Midcoast	$53	1102%
Quiktrip	$53	1102%
University Of Mary Hardin-Baylor	$56	1164%
Independent Medical System	$58	1206%
Curative	$63	1310%
First Health	$68	1414%
Healthsmart	$68 - $73	1414%
Private Health Care System	$73	1518%
Three Rivers	$87	1809%

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 $58.
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 Baylor Scott & White Medical Center Pflugerville 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.