CMS Price Transparency Data

Blood test, hemoglobin

Facility: Childrens Hospital of Wisconsin Fox Valley

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $25
  • Cash Discount Price: $17
  • vs. Medicare Baseline: 10.55x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Childrens Hospital of Wisconsin Fox Valley is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 10.55x the Medicare baseline. Located in 130 Second St, Neenah, WI.
Cash / Self-Pay
$17

Average discount available for prompt cash payment at this facility.

Insurance Median
$25

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$2.37

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $2.37 (100%)
Cash / Self-Pay: $17 (717%)
Insurance Median: $25 (1055%)
Cash: $17 (717% of Medicare)
Ins. Median: $25 (1055% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $2.37 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 1055% of the Medicare baseline (a markup of 955%). 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 $2 84%
My Choice Wisconsin $2 - $3 84%
UnitedHealthcare $2 - $24 84%
Blue Cross Blue Shield $3 - $30 127%
Icare $3 127%
Managed Health Services $3 127%
Molina Healthcare Of Wisconsin $3 127%
Froedtert Health $22 - $27 928%
Medical College Of Wisconsin $22 928%
Network Health Plan $22 928%
Advocate Aurora Healthcare $24 1013%
Aspirus Health Plan $24 1013%
Common Ground Healthcare Cooperative $24 - $27 1013%
Trilogy Health Solutions $24 - $27 1013%
Wps Health Plan $24 - $28 1013%
Centivo $25 1055%
Dean Health Plan $25 1055%
Employer Health Care Alliance Cooperative $25 1055%
Group Health Cooperative Of Eau Claire $25 1055%
Health Partners $25 - $28 1055%
Oan Llc $25 1055%
Security Health Plan $26 1097%
America'S Ppo $27 1139%
Health Payment Systems $27 1139%
Praire States $27 1139%
Quartz Health Insurance $27 1139%
Sheboygan Employer'S Health Network $27 1139%
Aetna $28 1181%
Bellin Thedacare $28 1181%
Cigna $28 1181%
Group Health Cooperative Of South Central Wisconsin $28 1181%
Healthsmart $28 1181%
Prevea Health Network $28 1181%
Multiplan $29 - $30 1224%
Coventry Health Care $30 1266%

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