CMS Price Transparency Data

Blood test, ferritin (iron stores)

Facility: St Nicholas Hospital

Billing Code: 82728 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82728
  • Insurance Median: $75
  • Cash Discount Price: $81
  • vs. Medicare Baseline: 5.50x Medicare
The contracted insurance negotiated median rate for a Blood test, ferritin (iron stores) at St Nicholas Hospital is $75. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $81. Compared to the federal Medicare reimbursement reference rate of $13.63, this hospital’s rate is 5.50x the Medicare baseline. Located in 3100 Superior Ave, Sheboygan, WI.
Cash / Self-Pay
$81

Average discount available for prompt cash payment at this facility.

Insurance Median
$75

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$13.63

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $13.63 (100%)
Cash / Self-Pay: $81 (594%)
Insurance Median: $75 (550%)
Cash: $81 (594% of Medicare)
Ins. Median: $75 (550% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $13.63 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 550% of the Medicare baseline (a markup of 450%). 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 $14 - $123 103%
Blue Cross Blue Shield $14 - $123 103%
Community Care Family Care $14 103%
Humana $14 - $123 103%
Managed Health Services $14 103%
Medica $14 - $123 103%
Medicaid / KanCare $14 103%
Medicare (plans) $14 - $123 103%
Meridian Health Plan $14 103%
Molina Healthcare $14 - $123 103%
Security Health Plan $14 - $124 103%
UnitedHealthcare $14 - $123 103%
Triology $15 - $97 110%
P360 Small Group $16 117%
Prevea Health Network $16 117%
Naphcare $31 - $277 227%
Molina Healthcare Of Wi $62 455%
Hshs Employees $67 492%
Arise Health Plan $74 543%
Wea Provider Network $76 - $89 558%
Cigna $86 631%
Interplan $86 631%
Network Health Plan $86 631%
Health Care Alliance $90 660%
Health Eos $92 675%
Healthsmart $92 675%
Wisconsin Physician Service $98 719%
Multiplan/Phcs $103 756%
Choicecare $105 770%
North Central Healthcare Alliance $113 829%
First Health $117 858%
Caterpillar, Inc. $123 902%
Cofinity $123 902%
Live360 $123 902%

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