CMS Price Transparency Data

Blood test, sodium

Facility: Fort Memorial Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $6
  • Cash Discount Price: $34
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Fort Memorial Hospital is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $34. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 1.25x the Medicare baseline. Located in 611 Sherman Ave E, Fort Atkinson, WI.
Cash / Self-Pay
$34

Average discount available for prompt cash payment at this facility.

Insurance Median
$6

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: $34 (707%)
Insurance Median: $6 (125%)
Cash: $34 (707% of Medicare)
Ins. Median: $6 (125% 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
Blue Cross Blue Shield $2 - $6 42%
Dean Health Plan $2 - $43 42%
Managed Health Services $2 42%
Medicaid / KanCare $2 42%
Quartz $2 - $27 42%
UnitedHealthcare $2 - $8 42%
Molina $4 83%
Humana $5 104%
Centivo $6 125%
Veteran Evaluation Services $6 125%
Aetna $42 - $79 873%
Group Health Cooperative $68 - $250 1414%
Alliance $75 1559%
Mercycare $78 1622%
Trilogy $92 1913%
Cigna $100 2079%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 611 Sherman Ave E, Fort Atkinson, WI 53538
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals