CMS Price Transparency Data

Blood test, thyroid (TSH)

Facility: Fort Memorial Hospital

Billing Code: 84443 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84443
Insurance Median: $21
Cash Discount Price: $64
vs. Medicare Baseline: 1.25x Medicare

The contracted insurance negotiated median rate for a Blood test, thyroid (TSH) at Fort Memorial Hospital is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $64. Compared to the federal Medicare reimbursement reference rate of $16.8, this hospital’s rate is 1.25x the Medicare baseline. Located in 611 Sherman Ave E, Fort Atkinson, WI.

Cash / Self-Pay

$64

Average discount available for prompt cash payment at this facility.

Insurance Median

$21

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$16.8

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $16.8 (100%)

Cash / Self-Pay: $64 (381%)

Insurance Median: $21 (125%)

Cash: $64 (381% of Medicare)

Ins. Median: $21 (125% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $16.8 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$5 - $21	30%
Dean Health Plan	$5 - $149	30%
Managed Health Services	$5	30%
Medicaid / KanCare	$5	30%
Quartz	$5 - $96	30%
UnitedHealthcare	$5 - $29	30%
Molina	$13	77%
Humana	$17	101%
Centivo	$20 - $21	119%
Veteran Evaluation Services	$21	125%
Aetna	$80 - $148	476%
Group Health Cooperative	$128 - $252	762%
Alliance	$142	845%
Mercycare	$147	875%
Trilogy	$174	1036%
Cigna	$188	1119%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $64.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84443.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Fort Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 84443.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.