CMS Price Transparency Data

Blood test, amylase

Facility: St Nicholas Hospital

Billing Code: 82150 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82150
  • Insurance Median: $23
  • Cash Discount Price: $54
  • vs. Medicare Baseline: 3.55x Medicare
The contracted insurance negotiated median rate for a Blood test, amylase at St Nicholas Hospital is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $54. Compared to the federal Medicare reimbursement reference rate of $6.48, this hospital’s rate is 3.55x the Medicare baseline. Located in 3100 Superior Ave, Sheboygan, WI.
Cash / Self-Pay
$54

Average discount available for prompt cash payment at this facility.

Insurance Median
$23

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$6.48

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $6.48 (100%)
Cash / Self-Pay: $54 (833%)
Insurance Median: $23 (355%)
Cash: $54 (833% of Medicare)
Ins. Median: $23 (355% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $6.48 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 355% of the Medicare baseline (a markup of 255%). 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
Aetna $6 - $82 93%
Blue Cross Blue Shield $6 - $23 93%
Humana $6 - $70 93%
Medica $6 93%
Medicare (plans) $6 93%
Molina Healthcare $6 - $7 93%
UnitedHealthcare $6 - $8 93%
Community Care Family Care $7 108%
Managed Health Services $7 108%
Medicaid / KanCare $7 108%
Meridian Health Plan $7 108%
Security Health Plan $7 - $52 108%
Triology $7 - $65 108%
P360 Small Group $8 123%
Prevea Health Network $8 123%
Naphcare $15 231%
Molina Healthcare Of Wi $41 633%
Hshs Employees $44 679%
Arise Health Plan $49 756%
Wea Provider Network $51 - $59 787%
Cigna $57 880%
Interplan $57 880%
Network Health Plan $57 880%
Health Care Alliance $60 926%
Health Eos $62 957%
Healthsmart $62 957%
Wisconsin Physician Service $66 1019%
Multiplan/Phcs $69 1065%
Choicecare $70 1080%
North Central Healthcare Alliance $75 1157%
First Health $78 1204%
Caterpillar, Inc. $82 1265%
Cofinity $82 1265%
Live360 $82 1265%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3100 Superior Ave, Sheboygan, WI 53081
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals