CMS Price Transparency Data

Drug screening test

Facility: HSHS St Clare Memorial Hospital

Billing Code: G0480 (HCPCS)

The BaseRate · fair price medium confidence

A fair price for this

$141

about 1.2× the $114 Medicare rate · typically $80–$312

modeled estimate · not a bill or quote

What this hospital charges insurers

$161

About the fair price

about $20 over the fair price · 1.4× Medicare

Medicare pays $114 Fair price $141 This hospital $161 Cash price $144 Hospital's list price $218

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

Highest price of the 9 WI hospitals we have prices for — worth calling around.

Cheapest $74 Priciest $161

Black dot = this hospital, among the 9 WI hospitals with a price for this procedure. Full list below.

A fair price for a Drug screening test is about $141 (about 1.2× the $114 Medicare rate). HSHS St Clare Memorial Hospital charges insurers about $161, or about $144 in cash — about the fair price. Located in Oconto Falls, WI.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$42 - $349	37%
Blue Cross Blue Shieldmajor	$42 - $349	37%
Aetnamajor	$42 - $349	37%
Cignamajor	$109 - $218	95%
Humanamajor	$42 - $349	37%
Health Net	$149	130%
Meridian	$64	56%
Molina	$42 - $349	37%
Security Health Plan	$42 - $352	37%
+ 16 smaller / regional plans	$64 - $349

Government programs also on file: Medicaid.

Excludes 6 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 144), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the HCPCS code on your bill matches exactly: G0480.

Insurance Before you use insurance

Call your insurance company to confirm HSHS St Clare Memorial Hospital is in-network.
Ask your insurer whether prior approval is required for HCPCS code G0480.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at HSHS St Clare Memorial Hospital

Compare: Drug screening test at other WI hospitals

Insurance negotiated median for the same procedure, sorted lowest first.