CMS Price Transparency Data

Blood test, sodium

Facility: Astria Toppenish Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $8
  • Cash Discount Price: $64
  • vs. Medicare Baseline: 1.66x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Astria Toppenish Hospital is $8. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $64. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 1.66x the Medicare baseline. Located in 502 W Fourth Ave, Toppenish, WA.
Cash / Self-Pay
$64

Average discount available for prompt cash payment at this facility.

Insurance Median
$8

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: $64 (1331%)
Insurance Median: $8 (166%)
Cash: $64 (1331% of Medicare)
Ins. Median: $8 (166% 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.

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
Medicaid / KanCare $3 - $15 62%
Ambetter / Centene $4 83%
Molina $4 83%
UnitedHealthcare $4 - $81 83%
Va $4 83%
Aetna $5 - $86 104%
Cigna $5 104%
Humana $5 - $98 104%
Li $5 104%
Medicare (plans) $5 - $81 104%
Tricare $5 104%
Zenith $5 104%
Molina_Exchange $6 125%
Kaiser $18 374%
Regence $33 686%
Premera $37 769%
Premera_Affordable_Care $37 769%
Chpw_Cascade_Care $62 1289%
First_Choice $68 1414%
Tpsc $76 1580%
Bcchp $98 2037%
Great_Rivers $98 2037%
Healthcomp $98 2037%
Washington_State_Hca $98 2037%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 502 W Fourth Ave, Toppenish, WA 98948
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals