CMS Price Transparency Data

Blood test, sodium

Facility: Unitypoint Health - Meriter

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $20
  • Cash Discount Price: $65
  • vs. Medicare Baseline: 4.16x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Unitypoint Health - Meriter is $20. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $65. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 4.16x the Medicare baseline. Located in 202 S Park St, Madison, WI.
Cash / Self-Pay
$65

Average discount available for prompt cash payment at this facility.

Insurance Median
$20

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: $65 (1351%)
Insurance Median: $20 (416%)
Cash: $65 (1351% of Medicare)
Ins. Median: $20 (416% 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 416% of the Medicare baseline (a markup of 316%). 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
UnitedHealthcare $3 - $34 62%
Aspirus $5 - $49 104%
Blue Cross Blue Shield $5 - $77 104%
Humana $5 104%
Illinicare $5 104%
Meridiancare $5 104%
Prevea 360 $5 - $69 104%
Wellmark Uph Self-Funded $5 - $47 104%
Health Partners Open Network $7 - $30 146%
Cigna $15 - $24 312%
Security Health Plan $16 - $25 333%
Mercy Care $19 - $27 395%
Medical Associates Health Plan $20 - $29 416%
Quartz $25 520%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 202 S Park St, Madison, WI 53715
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals