CMS Price Transparency Data

Culture, bacterial

Facility: Childrens Hospital of Wisconsin Fox Valley

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $77
  • Cash Discount Price: $53
  • vs. Medicare Baseline: 8.93x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Childrens Hospital of Wisconsin Fox Valley is $77. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $53. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 8.93x the Medicare baseline. Located in 130 Second St, Neenah, WI.
Cash / Self-Pay
$53

Average discount available for prompt cash payment at this facility.

Insurance Median
$77

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$8.62

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.62 (100%)
Cash / Self-Pay: $53 (615%)
Insurance Median: $77 (893%)
Cash: $53 (615% of Medicare)
Ins. Median: $77 (893% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.62 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 893% of the Medicare baseline (a markup of 793%). 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 $9 104%
Managed Health Services $9 104%
Molina Healthcare Of Wisconsin $9 104%
My Choice Wisconsin $9 - $10 104%
UnitedHealthcare $9 - $73 104%
Blue Cross Blue Shield $10 - $91 116%
Icare $11 128%
Froedtert Health $67 - $82 777%
Medical College Of Wisconsin $67 777%
Network Health Plan $69 800%
Aspirus Health Plan $72 835%
Common Ground Healthcare Cooperative $72 - $82 835%
Trilogy Health Solutions $72 - $82 835%
Wps Health Plan $73 - $87 847%
Advocate Aurora Healthcare $74 858%
Centivo $75 870%
Health Partners $75 - $85 870%
Employer Health Care Alliance Cooperative $76 882%
Dean Health Plan $77 893%
Group Health Cooperative Of Eau Claire $77 893%
Oan Llc $77 893%
Security Health Plan $80 928%
Health Payment Systems $81 940%
Praire States $82 951%
Quartz Health Insurance $82 951%
Sheboygan Employer'S Health Network $82 951%
America'S Ppo $84 974%
Aetna $85 - $86 986%
Bellin Thedacare $87 1009%
Cigna $87 1009%
Group Health Cooperative Of South Central Wisconsin $87 1009%
Healthsmart $87 1009%
Prevea Health Network $87 1009%
Multiplan $88 - $91 1021%
Coventry Health Care $91 1056%

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