CMS Price Transparency Data

Blood test, thyroid (TSH)

Facility: Stoughton Hospital

Billing Code: 84443 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84443
Insurance Median: $94
Cash Discount Price: $136
vs. Medicare Baseline: 5.60x Medicare

The contracted insurance negotiated median rate for a Blood test, thyroid (TSH) at Stoughton Hospital is $94. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $136. Compared to the federal Medicare reimbursement reference rate of $16.8, this hospital’s rate is 5.60x the Medicare baseline. Located in 900 Ridge St, Stoughton, WI.

Cash / Self-Pay

$136

Average discount available for prompt cash payment at this facility.

Insurance Median

$94

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: $136 (810%)

Insurance Median: $94 (560%)

Cash: $136 (810% of Medicare)

Ins. Median: $94 (560% 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 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.

Consult Patient Advocate

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
Medicaid / KanCare	$13	77%
Alliance - All Plans	$42	250%
Tricare	$59	351%
Healthnet Mcr Adv - All Plans	$66	393%
Dean Health Insurance Med Adv	$69	411%
Humana	$69 - $223	411%
Quartz Mcr Adv	$69	411%
Security Health/First Health - All Plans	$69	411%
Aetna	$74 - $211	440%
Dean Health Insurance Comm - All Other Plans	$94	560%
Dean Health Insurance Epo	$94	560%
UnitedHealthcare	$109 - $198	649%
Geha - All Plans	$186	1107%
Cigna	$198	1179%
Wisconsin Ppo Ppa Direct - All Plans	$198	1179%
Quartz Health Solutions - All Other Lans	$211	1256%
Blue Cross Blue Shield	$216	1286%
Wps - All Plans	$223	1327%

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 $136.
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 Stoughton 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.