CMS Price Transparency Data

Blood test, sodium

Facility: Carilion Stonewall Jackson Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $50
  • Cash Discount Price: $27
  • vs. Medicare Baseline: 10.40x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Carilion Stonewall Jackson Hospital is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 10.40x the Medicare baseline. Located in 1 Health Circle, Lexington, VA.
Cash / Self-Pay
$27

Average discount available for prompt cash payment at this facility.

Insurance Median
$50

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: $27 (561%)
Insurance Median: $50 (1040%)
Cash: $27 (561% of Medicare)
Ins. Median: $50 (1040% 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 1040% of the Medicare baseline (a markup of 940%). 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
Abh of VA (Formerly Coventry) $5 104%
Abh of Wva (Formerly Coventry) $5 104%
Blue Cross Blue Shield $5 104%
Humana $5 104%
Sentara Health Plan $5 - $48 104%
UnitedHealthcare $5 - $64 104%
Aetna $40 - $52 832%
Gateway - Tier 3 $43 894%
Vhn - Ultra $48 998%
Connecticare $55 1143%
Cigna $62 1289%
Gateway - Tier 2 $62 1289%
Vhn - Plus $62 1289%
Integrated Health Plan $66 1372%
Vhn $66 1372%
Vhn - Link $70 1455%
Beech Street $72 1497%
Gateway - Tier 1 $74 1538%
Vhn - Secondary Payors $74 1538%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Health Circle, Lexington, VA 24450
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals