CMS Price Transparency Data

Blood test, sodium

Facility: St Joseph's Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $70
  • Cash Discount Price: $79
  • vs. Medicare Baseline: 14.55x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at St Joseph's Hospital is $70. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $79. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 14.55x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$79

Average discount available for prompt cash payment at this facility.

Insurance Median
$70

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: $79 (1642%)
Insurance Median: $70 (1455%)
Cash: $79 (1642% of Medicare)
Ins. Median: $70 (1455% 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 1455% of the Medicare baseline (a markup of 1355%). 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
Meridian Health Plan $9 187%
Molina Healthcare $9 - $22 187%
UnitedHealthcare $10 - $110 208%
Caterpillar, Inc. $10 208%
Cigna $12 249%
Sae Hospice $22 457%
Humana $22 457%
Aetna $22 - $77 457%
Clear Spring Health of Illinois $22 457%
Blue Cross Blue Shield $22 457%
Amish Community $31 644%
Naphcare $46 956%
Celtic Insurance Company $48 998%
Claim Doc $55 1143%
Hopetrust $55 1143%
Wellfirst $70 1455%
First Health $81 1684%
Healthlink $94 1954%
Multiplan/Phcs $94 1954%
Provider Network of America $99 2058%
Healthcare Finest Network (Hfn) $99 2058%
Current Health Solutions $110 2287%
Health Alliance Medical Plans $110 2287%
Qtc Medical Group of Illinois $110 2287%
Consociate Group $110 2287%
Mental Health Network $110 2287%
Healthscope $110 2287%
Illinois Breast and Cervical Cancer Program $110 2287%
Interplan $110 2287%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals