CMS Price Transparency Data

Blood test, glucose (blood sugar)

Facility: St Nicholas Hospital

Billing Code: 82947 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82947
  • Insurance Median: $22
  • Cash Discount Price: $24
  • vs. Medicare Baseline: 5.60x Medicare
The contracted insurance negotiated median rate for a Blood test, glucose (blood sugar) at St Nicholas Hospital is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $24. Compared to the federal Medicare reimbursement reference rate of $3.93, this hospital’s rate is 5.60x the Medicare baseline. Located in 3100 Superior Ave, Sheboygan, WI.
Cash / Self-Pay
$24

Average discount available for prompt cash payment at this facility.

Insurance Median
$22

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$3.93

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $3.93 (100%)
Cash / Self-Pay: $24 (611%)
Insurance Median: $22 (560%)
Cash: $24 (611% of Medicare)
Ins. Median: $22 (560% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $3.93 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 560% of the Medicare baseline (a markup of 460%). 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 $4 - $37 102%
Blue Cross Blue Shield $4 - $37 102%
Community Care Family Care $4 102%
Humana $4 - $37 102%
Managed Health Services $4 102%
Medica $4 - $37 102%
Medicaid / KanCare $4 102%
Medicare (plans) $4 - $37 102%
Meridian Health Plan $4 102%
Molina Healthcare $4 - $37 102%
Security Health Plan $4 - $37 102%
Triology $4 - $29 102%
UnitedHealthcare $4 - $37 102%
P360 Small Group $5 127%
Prevea Health Network $5 127%
Naphcare $9 229%
Molina Healthcare Of Wi $18 458%
Hshs Employees $20 509%
Arise Health Plan $22 560%
Wea Provider Network $23 - $27 585%
Cigna $26 662%
Interplan $26 662%
Network Health Plan $26 662%
Health Care Alliance $27 687%
Health Eos $28 712%
Healthsmart $28 712%
Wisconsin Physician Service $30 763%
Choicecare $31 789%
Multiplan/Phcs $31 789%
North Central Healthcare Alliance $34 865%
First Health $35 891%
Caterpillar, Inc. $37 941%
Cofinity $37 941%
Live360 $37 941%

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