CMS Price Transparency Data

Blood test, thyroid (TSH)

Facility: Tomah Memorial Hospital

Billing Code: 84443 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84443
  • Insurance Median: $41
  • Cash Discount Price: $69
  • vs. Medicare Baseline: 2.44x Medicare
The contracted insurance negotiated median rate for a Blood test, thyroid (TSH) at Tomah Memorial Hospital is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $16.8, this hospital’s rate is 2.44x the Medicare baseline. Located in 501 Gopher Dr, Tomah, WI.
Cash / Self-Pay
$69

Average discount available for prompt cash payment at this facility.

Insurance Median
$41

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: $69 (411%)
Insurance Median: $41 (244%)
Cash: $69 (411% of Medicare)
Ins. Median: $41 (244% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 244% of the Medicare baseline (a markup of 144%). 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
Blue Cross Blue Shield $17 - $111 101%
Independent Care Mcaid $17 101%
Managed Hlth Mcaid - All Plans $17 101%
Quartz Mcaid $17 101%
Security Hp Mcaid $17 101%
Va Ccn - All Plans $20 119%
Group Hlth Mcr Adv - All Plans $41 244%
Humana $41 - $111 244%
Independent Care Mcr - All Other Plans $41 244%
Quartz Mcr Adv $41 244%
Security Hp Mcr Adv $41 244%
UnitedHealthcare $41 - $113 244%
Aetna $78 - $102 464%
Cigna $91 - $117 542%
Security Hp Comm - All Other Plans $102 607%
Quartz Comm - All Other Plans $108 643%
The Alliance - All Plans $112 667%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 501 Gopher Dr, Tomah, WI 54660
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals