CMS Price Transparency Data

Blood antibody screen

Facility: Childrens Hospital of Wisconsin Fox Valley

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $72
  • Cash Discount Price: $50
  • vs. Medicare Baseline: 1.35x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Childrens Hospital of Wisconsin Fox Valley is $72. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.35x the Medicare baseline. Located in 130 Second St, Neenah, WI.
Cash / Self-Pay
$50

Average discount available for prompt cash payment at this facility.

Insurance Median
$72

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$53.24

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $53.24 (100%)
Cash / Self-Pay: $50 (94%)
Insurance Median: $72 (135%)
Cash: $50 (94% of Medicare)
Ins. Median: $72 (135% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $53.24 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.

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 9%
My Choice Wisconsin $5 - $6 9%
UnitedHealthcare $5 - $68 9%
Blue Cross Blue Shield $6 - $86 11%
Managed Health Services $6 11%
Molina Healthcare Of Wisconsin $6 11%
Icare $7 13%
Froedtert Health $63 - $76 118%
Medical College Of Wisconsin $63 118%
Network Health Plan $64 120%
Aspirus Health Plan $68 128%
Common Ground Healthcare Cooperative $68 - $76 128%
Trilogy Health Solutions $68 - $76 128%
Wps Health Plan $68 - $81 128%
Advocate Aurora Healthcare $69 130%
Centivo $70 131%
Health Partners $70 - $79 131%
Employer Health Care Alliance Cooperative $71 133%
Dean Health Plan $72 135%
Group Health Cooperative Of Eau Claire $72 135%
Oan Llc $72 135%
Security Health Plan $75 141%
Health Payment Systems $76 143%
Praire States $76 143%
Quartz Health Insurance $76 143%
Sheboygan Employer'S Health Network $76 143%
America'S Ppo $78 147%
Aetna $79 - $80 148%
Bellin Thedacare $81 152%
Cigna $81 152%
Group Health Cooperative Of South Central Wisconsin $81 152%
Healthsmart $81 152%
Prevea Health Network $81 152%
Multiplan $82 - $86 154%
Coventry Health Care $86 162%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 130 Second St, Neenah, WI 54956
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens