CMS Price Transparency Data

Blood test, sodium

Facility: University of Wi Hospitals & Clinics Authority

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84295
Insurance Median: $36
Cash Discount Price: $37
vs. Medicare Baseline: 7.48x Medicare

The contracted insurance negotiated median rate for a Blood test, sodium at University of Wi Hospitals & Clinics Authority is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 7.48x the Medicare baseline. Located in 600 Highland Avenue, Madison, WI.

Cash / Self-Pay

$37

Average discount available for prompt cash payment at this facility.

Insurance Median

$36

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: $37 (769%)

Insurance Median: $36 (748%)

Cash: $37 (769% of Medicare)

Ins. Median: $36 (748% 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 748% of the Medicare baseline (a markup of 648%). 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
Aetna	$5 - $50	104%
Blue Cross Blue Shield	$5 - $59	104%
Humana	$5	104%
Medicare (plans)	$5	104%
UnitedHealthcare	$5 - $39	104%
Alliance_Premier_Network	$30	624%
Mercycare	$31	644%
Triology	$32 - $38	665%
Security_Health_Plan	$33 - $39	686%
Employer'S_Coalition_On_Health	$34 - $48	707%
Alliance	$35	728%
Hfn	$35 - $48	728%
Aspirus_Health_Plan	$36	748%
Beloit_Health_System	$36	748%
United_Healthcare	$36 - $53	748%
Cigna	$37	769%
Health_Partners_Insurance	$38	790%
Health_Payment_Systems	$38	790%
Dean_Health_Plan	$40	832%
Medical_Associates	$41	852%
Employers_Healthcare_Coalition_Of_Wi	$43	894%
Wps	$43 - $47	894%
Aspirus_Network_Inc	$48	998%
Chorus_Community	$50	1040%
Ghc_Eau_Claire_Health_Plan	$50	1040%
Multiplan	$50 - $57	1040%
Sheybogan_Employers_Health_Network	$50	1040%
Coventry	$53	1102%
Dean_Care	$53	1102%
Healthsmart	$55	1143%

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 $37.
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 University of Wi Hospitals & Clinics Authority 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.