CMS Price Transparency Data

Blood test, sodium

Facility: Aurora Medical Ctr Oshkosh

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84295
Insurance Median: $21
Cash Discount Price: $20
vs. Medicare Baseline: 4.37x Medicare

The contracted insurance negotiated median rate for a Blood test, sodium at Aurora Medical Ctr Oshkosh is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 4.37x the Medicare baseline. Located in 855 N Westhaven Drive, Oshkosh, WI.

Cash / Self-Pay

$20

Average discount available for prompt cash payment at this facility.

Insurance Median

$21

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: $20 (416%)

Insurance Median: $21 (437%)

Cash: $20 (416% of Medicare)

Ins. Median: $21 (437% 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 437% of the Medicare baseline (a markup of 337%). 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
UnitedHealthcare	$4 - $38	83%
Aurora Caregiver	$5	104%
Blue Cross Blue Shield	$5 - $38	104%
Common Ground	$10 - $11	208%
Aetna	$11 - $37	229%
Centivo	$11	229%
Health Payment Systems	$12	249%
Quartz One	$12	249%
Healthpartners	$13 - $34	270%
Molina Exchange	$13	270%
Cigna	$14 - $38	291%
Everpointe Elite	$14	291%
Hs Technology	$14	291%
Quartz Group	$14	291%
Wisconsin Physician Service	$16	333%
Trilogy	$17	353%
Health Eos Plus	$21 - $27	437%
Health Eos	$28 - $36	582%

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 $20.
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 Aurora Medical Ctr Oshkosh 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.