CMS Price Transparency Data

Blood test, sodium

Facility: Childrens Hospital of Wisconsin

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $98
  • Cash Discount Price: $68
  • vs. Medicare Baseline: 20.37x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Childrens Hospital of Wisconsin is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $68. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 20.37x the Medicare baseline. Located in 9000 W Wisconsin Ave, Milwaukee, WI.
Cash / Self-Pay
$68

Average discount available for prompt cash payment at this facility.

Insurance Median
$98

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$4.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.81 (100%)
Cash / Self-Pay: $68 (1414%)
Insurance Median: $98 (2037%)
Cash: $68 (1414% of Medicare)
Ins. Median: $98 (2037% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $4.81 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 2037% of the Medicare baseline (a markup of 1937%). 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
Chorus Community Health Plan $5 104%
Managed Health Services $5 104%
Molina Healthcare Of Wisconsin $5 104%
My Choice Wisconsin $5 104%
UnitedHealthcare $5 - $93 104%
Blue Cross Blue Shield $6 - $117 125%
Icare $6 125%
Froedtert Health $86 - $104 1788%
Medical College Of Wisconsin $86 1788%
Network Health Plan $87 1809%
Aspirus Health Plan $92 1913%
Common Ground Healthcare Cooperative $92 - $104 1913%
Trilogy Health Solutions $92 - $104 1913%
Wps Health Plan $93 - $110 1933%
Advocate Aurora Healthcare $95 1975%
Centivo $96 1996%
Employer Health Care Alliance Cooperative $96 1996%
Health Partners $96 - $108 1996%
Dean Health Plan $98 2037%
Group Health Cooperative Of Eau Claire $98 2037%
Oan Llc $98 2037%
Security Health Plan $102 2121%
Health Payment Systems $104 2162%
Praire States $104 2162%
Quartz Health Insurance $104 2162%
Sheboygan Employer'S Health Network $104 2162%
Mayo Clinic Health Solutions $107 2225%
Aetna $108 - $109 2245%
Bellin Thedacare $110 2287%
Cigna $110 2287%
Group Health Cooperative Of South Central Wisconsin $110 2287%
Prevea Health Network $110 2287%
Multiplan $112 - $117 2328%
Coventry Health Care $117 2432%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9000 W Wisconsin Ave, Milwaukee, WI 53226
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens