CMS Price Transparency Data

Blood test, sodium

Facility: Samuel Mahelona Memorial Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84295
Insurance Median: $115
Cash Discount Price: $146
vs. Medicare Baseline: 23.91x Medicare

The contracted insurance negotiated median rate for a Blood test, sodium at Samuel Mahelona Memorial Hospital is $115. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $146. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 23.91x the Medicare baseline. Located in 4800 Kawaihau Road, Kapaa, HI.

Cash / Self-Pay

$146

Average discount available for prompt cash payment at this facility.

Insurance Median

$115

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: $146 (3035%)

Insurance Median: $115 (2391%)

Cash: $146 (3035% of Medicare)

Ins. Median: $115 (2391% 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 2391% of the Medicare baseline (a markup of 2291%). 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
Hawaii Western Management Group	$5	104%
Hawaii Medical Service Association	$6 - $115	125%
UnitedHealthcare	$7 - $115	146%
University Health Alliance	$12	249%
Kaiser Permanente	$110 - $207	2287%
Humana	$110 - $115	2287%
Ohana Health Plan	$110 - $115	2287%
Alohacare	$110 - $115	2287%
Devoted Health	$121 - $126	2516%
Health Management Network	$187 - $196	3888%
Mdx Hawaii	$213 - $223	4428%

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 $146.
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 Samuel Mahelona Memorial Hospital 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.