CMS Price Transparency Data

Blood test, magnesium

Facility: St Nicholas Hospital

Billing Code: 83735 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83735
  • Insurance Median: $44
  • Cash Discount Price: $49
  • vs. Medicare Baseline: 6.57x Medicare
The contracted insurance negotiated median rate for a Blood test, magnesium at St Nicholas Hospital is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $6.7, this hospital’s rate is 6.57x the Medicare baseline. Located in 3100 Superior Ave, Sheboygan, WI.
Cash / Self-Pay
$49

Average discount available for prompt cash payment at this facility.

Insurance Median
$44

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$6.7

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $6.7 (100%)
Cash / Self-Pay: $49 (731%)
Insurance Median: $44 (657%)
Cash: $49 (731% of Medicare)
Ins. Median: $44 (657% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $6.7 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 657% of the Medicare baseline (a markup of 557%). 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 $7 - $74 104%
Blue Cross Blue Shield $7 - $74 104%
Community Care Family Care $7 104%
Humana $7 - $74 104%
Managed Health Services $7 104%
Medica $7 - $74 104%
Medicaid / KanCare $7 104%
Medicare (plans) $7 - $74 104%
Meridian Health Plan $7 104%
Molina Healthcare $7 - $74 104%
Security Health Plan $7 - $75 104%
Triology $7 - $58 104%
UnitedHealthcare $7 - $74 104%
P360 Small Group $8 119%
Prevea Health Network $8 119%
Naphcare $15 224%
Molina Healthcare Of Wi $37 552%
Hshs Employees $40 597%
Arise Health Plan $44 657%
Wea Provider Network $46 - $53 687%
Cigna $52 776%
Interplan $52 776%
Network Health Plan $52 776%
Health Care Alliance $54 806%
Health Eos $56 836%
Healthsmart $56 836%
Wisconsin Physician Service $59 881%
Multiplan/Phcs $62 925%
Choicecare $63 940%
North Central Healthcare Alliance $68 1015%
First Health $70 1045%
Caterpillar, Inc. $74 1104%
Cofinity $74 1104%
Live360 $74 1104%

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