CMS Price Transparency Data

Blood test, lipase

Facility: Childrens Hospital of Wisconsin Fox Valley

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $119
  • Cash Discount Price: $82
  • vs. Medicare Baseline: 17.27x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Childrens Hospital of Wisconsin Fox Valley is $119. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $82. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 17.27x the Medicare baseline. Located in 130 Second St, Neenah, WI.
Cash / Self-Pay
$82

Average discount available for prompt cash payment at this facility.

Insurance Median
$119

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$6.89

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $6.89 (100%)
Cash / Self-Pay: $82 (1190%)
Insurance Median: $119 (1727%)
Cash: $82 (1190% of Medicare)
Ins. Median: $119 (1727% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $6.89 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 1727% of the Medicare baseline (a markup of 1627%). 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 $7 102%
My Choice Wisconsin $7 - $8 102%
UnitedHealthcare $7 - $113 102%
Blue Cross Blue Shield $8 - $141 116%
Managed Health Services $8 116%
Molina Healthcare Of Wisconsin $8 116%
Icare $9 131%
Froedtert Health $104 - $126 1509%
Medical College Of Wisconsin $104 1509%
Network Health Plan $106 1538%
Aspirus Health Plan $111 1611%
Common Ground Healthcare Cooperative $111 - $126 1611%
Trilogy Health Solutions $111 - $126 1611%
Wps Health Plan $113 - $134 1640%
Advocate Aurora Healthcare $114 1655%
Centivo $116 1684%
Health Partners $116 - $131 1684%
Employer Health Care Alliance Cooperative $117 1698%
Dean Health Plan $119 1727%
Group Health Cooperative Of Eau Claire $119 1727%
Oan Llc $119 1727%
Security Health Plan $123 1785%
Health Payment Systems $126 1829%
Praire States $126 1829%
Quartz Health Insurance $126 1829%
Sheboygan Employer'S Health Network $126 1829%
America'S Ppo $129 1872%
Aetna $131 - $132 1901%
Bellin Thedacare $134 1945%
Cigna $134 1945%
Group Health Cooperative Of South Central Wisconsin $134 1945%
Healthsmart $134 1945%
Prevea Health Network $134 1945%
Multiplan $135 - $141 1959%
Coventry Health Care $141 2046%

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