CMS Price Transparency Data

Blood test, sodium

Facility: Childrens Hospital of Wisconsin Fox Valley

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $33
  • Cash Discount Price: $22
  • vs. Medicare Baseline: 6.86x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Childrens Hospital of Wisconsin Fox Valley is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $22. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 6.86x the Medicare baseline. Located in 130 Second St, Neenah, WI.
Cash / Self-Pay
$22

Average discount available for prompt cash payment at this facility.

Insurance Median
$33

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: $22 (457%)
Insurance Median: $33 (686%)
Cash: $22 (457% of Medicare)
Ins. Median: $33 (686% 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 686% of the Medicare baseline (a markup of 586%). 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 - $31 104%
Blue Cross Blue Shield $6 - $39 125%
Icare $6 125%
Froedtert Health $29 - $35 603%
Medical College Of Wisconsin $29 603%
Network Health Plan $29 603%
Advocate Aurora Healthcare $31 644%
Aspirus Health Plan $31 644%
Common Ground Healthcare Cooperative $31 - $35 644%
Trilogy Health Solutions $31 - $35 644%
Wps Health Plan $31 - $37 644%
Centivo $32 665%
Employer Health Care Alliance Cooperative $32 665%
Health Partners $32 - $36 665%
Dean Health Plan $33 686%
Group Health Cooperative Of Eau Claire $33 686%
Oan Llc $33 686%
Health Payment Systems $34 707%
Security Health Plan $34 707%
America'S Ppo $35 728%
Praire States $35 728%
Quartz Health Insurance $35 728%
Sheboygan Employer'S Health Network $35 728%
Aetna $36 748%
Bellin Thedacare $37 769%
Cigna $37 769%
Group Health Cooperative Of South Central Wisconsin $37 769%
Healthsmart $37 769%
Multiplan $37 - $39 769%
Prevea Health Network $37 769%
Coventry Health Care $39 811%

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