CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Childrens Hospital of Wisconsin Fox Valley

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $228
  • Cash Discount Price: $156
  • vs. Medicare Baseline: 26.95x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Childrens Hospital of Wisconsin Fox Valley is $228. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $156. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 26.95x the Medicare baseline. Located in 130 Second St, Neenah, WI.
Cash / Self-Pay
$156

Average discount available for prompt cash payment at this facility.

Insurance Median
$228

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$8.46

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.46 (100%)
Cash / Self-Pay: $156 (1844%)
Insurance Median: $228 (2695%)
Cash: $156 (1844% of Medicare)
Ins. Median: $228 (2695% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.46 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 2695% of the Medicare baseline (a markup of 2595%). 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
My Choice Wisconsin $8 - $9 95%
UnitedHealthcare $8 - $216 95%
Chorus Community Health Plan $9 106%
Managed Health Services $9 106%
Molina Healthcare Of Wisconsin $9 106%
Blue Cross Blue Shield $10 - $270 118%
Icare $11 130%
Froedtert Health $199 - $242 2352%
Medical College Of Wisconsin $199 2352%
Network Health Plan $203 2400%
Aspirus Health Plan $213 2518%
Common Ground Healthcare Cooperative $213 - $242 2518%
Trilogy Health Solutions $213 - $242 2518%
Wps Health Plan $216 - $256 2553%
Advocate Aurora Healthcare $219 2589%
Centivo $222 2624%
Health Partners $222 - $250 2624%
Employer Health Care Alliance Cooperative $223 2636%
Dean Health Plan $228 2695%
Group Health Cooperative Of Eau Claire $228 2695%
Oan Llc $228 2695%
Security Health Plan $236 2790%
Health Payment Systems $241 2849%
Praire States $242 2861%
Quartz Health Insurance $242 2861%
Sheboygan Employer'S Health Network $242 2861%
America'S Ppo $248 2931%
Aetna $250 - $253 2955%
Bellin Thedacare $256 3026%
Cigna $256 3026%
Group Health Cooperative Of South Central Wisconsin $256 3026%
Healthsmart $256 3026%
Prevea Health Network $256 3026%
Multiplan $259 - $270 3061%
Coventry Health Care $270 3191%

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